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The management of tics


  • Potential conflict of interest: Dr. Shprecher has no financial conflicts of interest. Dr. Kurlan currently receives research support from Boehringer Ingelheim.

  • This article is part of the journal's online CME program. The CME activity including form, can be found online at


A tic is a stereotyped repetitive involuntary movement or sound, frequently preceded by premonitory sensations or urges. Most tic disorders are genetic or idiopathic in nature, possibly due to a developmental failure of inhibitory function within frontal-subcortical circuits modulating volitional movements. Currently available oral medications can reduce the severity of tics, but rarely eliminate them. Botulinum toxin injections can be effective if there are a few particularly disabling motor tics. Deep brain stimulation has been reported to be an effective treatment for the most severe cases, but remains unproven. A comprehensive evaluation accounting for secondary causes, psychosocial factors, and comorbid neuropsychiatric conditions is essential to successful treatment of tic disorders. © 2008 Movement Disorder Society

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