Examkin

Soru

Zorluk: OrtaChildhood and Neurodevelopmental Disorders

An 8-year-old boy is brought to the outpatient pediatric clinic by his father due to unusual facial movements. The father reports that for the past 4 months, the child has been frequently blinking his eyes forcefully and scrunching his nose. These movements occur multiple times a day, worsen when he is anxious about reading aloud, and are absent during sleep. The child does not make any repetitive sounds or vocalizations. Collateral history from his second-grade teacher confirms the facial movements; the teacher notes that while his academic performance is excellent, the boy has become increasingly withdrawn because classmates have started pointing out his "funny faces." The patient's early developmental milestones were met at appropriate ages, and a recent physical examination shows no other neurological abnormalities. The father is highly anxious and asks if his son has Tourette syndrome. Which of the following is the most likely diagnosis?

  1. Provisional tic disorderCevap
  2. B
    Tourette syndrome
  3. C
    Persistent (chronic) motor tic disorder
  4. D
    Autism spectrum disorder
  5. E
    Specific learning disorder

Cevap

The correct diagnosis is provisional tic disorder.
The correct diagnosis is provisional tic disorder. This patient presents with multiple motor tics (eye blinking, nose scrunching) but no vocal tics. Furthermore, the symptoms have been present for less than 1 year (specifically, 4 months). According to DSM-5 criteria, the presence of single or multiple motor and/or vocal tics for less than 1 year since onset meets the criteria for provisional tic disorder.

Adım Adım Çözüm

1
Evaluate the patient's presenting symptoms and clinical history.
The patient exhibits rapid, sudden, non-rhythmic motor movements (eye blinking, nose scrunching) without any accompanying vocalizations.
To correctly identify the type of symptom (motor tics vs. vocal tics vs. complex stereotypies).
2
Assess the duration of the patient's symptoms.
The motor tics have been present for exactly 4 months.
To apply the correct DSM-5 timeline criteria for differentiating various tic disorders.
3
Synthesize the symptom profile and timeline to determine the diagnosis.
The presence of motor tics without vocal tics, present for less than 1 year, leads directly to a diagnosis of provisional tic disorder.
To select the single most accurate diagnosis among the neurodevelopmental disorder options.

Anahtar Kavram

Differentiating provisional tic disorder from Tourette syndrome and persistent motor tic disorder based on the presence of vocal tics and the 1-year symptom duration threshold.
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Konular

Childhood and Neurodevelopmental Disorders

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