• The Journal of Pediatrics of Korean Medicine
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• v.15 no.2
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• pp.111-119
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• 2001

Tic disorder which is purposeless, repeated, unexpected, involuntary behavior and voice can be divided into motor, vocal tic. Tic disorder belongs to pediatic psychosomatic disease. In four clinical cases, patients between the age of 6 to 15 consisted of three males and one females. They all are the eldest or only son and have the parental behavioral, home background and studing problem. The patients appealed to eye blinking in tic early stage and belong to chronic motor or vocal tic disorder or transient tic disorder without tourette's disorder. When estimated by an appraisal standard of Yale Global Tic Severity Scale(YGTSS). Four patients administered Bosimgeunatang known to invigorating the heart, relieving mental stress improved.

• The Journal of Pediatrics of Korean Medicine
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• v.28 no.4
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• pp.118-124
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• 2014

Objectives The purpose of this study is to report 20 cases of tic disorder children who were treated by Kuibiondam-tang Gami. Methods We treated the tic disorder children with herbal medicine, Kuibiondam-tang Gami. Then we evaluated tic disorder by Yale Global Tic Severity Scale (YGTSS) and observed the progress of tic disorder. Results 20 children (male 17, female 3 / transient tic disorder 6, chronic motor or vocal tic disorder 13, Tourette's disorder 1) were studied, the average age of children was $8.45{\pm}2.08$ years, the average duration of illness was $16.55{\pm}13.63$ month and the mean of treatment was $13.20{\pm}9.29$ week. After the treatment, mean of YGTSS was reduced $36.35{\pm}9.84$ to $9.35{\pm}1.03$ and total effective rate was 95%. Conclusions Kuibiondam-tang Gami is effective for reducing tic symptom and improving general conditions in children.

• Journal of Oriental Neuropsychiatry
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• v.19 no.3
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• pp.219-229
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• 2008

Tics are sudden, painless, nonrhythmic behaviors that are either motor or vocal. As to DSM- VI diagnostic criteria, chronic tic disorder is either single or multiple motor or phonic tics, but not both, which are present for more than a year. In this case, a male patient was diagnosed tics disorder at 8 years old. He has suffered for 15 years and his symptom was simple motor tics of neck, both arms and both legs, not vocal tics. So we diagnosed him as the chronic tic disorder. The severity score headache was assessed using the Visual Analog Scales. The severity score tics was assessed at baseline using the Yale Global Tic Severity Scale (YGTSS) and we compared score of before with after treatment. We treated him with oriental medication( herbal medicine, acupuncture, cry cupping) and progressive muscle relaxation. After this treatment, chronic insomnia and extreme headache were disappeard and the symptoms of tics were mildly decreased.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.4
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• pp.236-241
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• 2023

Objectives: According to the 10th revision of the International Classification of Diseases, the main categories of tic disorders (F95.0, F95.1, and F95.2) follow a diagnostic hierarchy based on the duration and diversity of tic symptoms. The present study investigated the use of this diagnostic hierarchy in real-world clinical practice. Methods: Based on the National Health Insurance Service-National Health Information Database, the diagnosis of transient tic disorder (F95.0) made after a diagnosis of chronic motor or vocal tic disorder (F95.1) or Tourette's syndrome (F95.2) and diagnosis of chronic motor or vocal tic disorder (F95.1) made after a diagnosis of Tourette's syndrome (F95.2) were referred to as type A errors. The diagnosis of transient tic disorder (F95.0) repeated after a period of >12 months was referred to as type B error. Demographic and clinical differences according to the diagnostic error types were analyzed using analysis of variance, Student's t-tests, and chi-squared tests. Results: Most participants (96.5%) were without errors in the diagnosis of tic disorders. Higher proportions of males (p=0.005) and antipsychotic prescriptions (p<0.001) were observed in patients with type A or B diagnostic errors. A higher proportion of health insurance holders was observed among those with type A errors (p=0.027). Conclusion: Errors were absent in majority of the tic diagnoses in real-world clinical practice in terms of the diagnostic hierarchy.

• The Journal of Pediatrics of Korean Medicine
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• v.17 no.1
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• pp.141-155
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• 2003

Method : Chronic motor tic or vocal tic disorders are characterized which have one of the two kinds of tics for more than a year. It is characterized chronic motor tic or vocal tic disorders that have one of the two kinds of tics for more than a year. But Tourette's disorder is a disease which has one or more motor tics and vocal tics for more than a year. Contemporary empirical studies have suggested the rate of comorbid attention-deficit hyperactivity disorder(ADHD) or obsessive compulsive disorder(OCD) in children with tic disorders be high. Objects : As society is confusing, tic disorders are increasing. Therefore, determining the treatment strategy in children with tic disorders is very important. So we studied the literatures of traditional chinese medicine about tic disorders and reported the results. Results : The principals for medical treatment were So-gan(疏肝), I-gi(理氣), Sik-pung(熄風), Gin-kyung(鎭痙), Chung-oel(淸熱) etc. Medicines treatment is used more than acupuncture treatment. The herbs are used Uncariae ramulus et Uncus(釣鉤藤), Paeoniae Radix Alba(白芍藥), Poria(白茯岺), Glycyrrhizae Radix(甘草), Bupleuri Radi.x(柴胡), Fossilia ossis Mastodi(龍骨) etc. in the order named. Acupuncture points were used Naegwan(PC6), Shinmuin(HT7), P'ungnyur4(ST40), Paek'oe. (GV20), Chung-wan(CV12), Samumgye(SP6), Kongson(SP4), T'aech'ung(LR3) and so on.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.33 no.4
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• pp.91-98
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• 2022

Objectives: Comprehensive behavioral intervention for tics (CBIT) is effective in children with chronic tic disorders. This study aimed to assess the effect of group-based CBIT (group-CBIT) on tic severity and comorbid symptoms. We compared the efficacy of group CBIT with that of a control. Methods: Thirty children with chronic tic disorder or Tourette's disorder were enrolled in this study. Eighteen were assigned to the group-CBIT for eight sessions, and 12 were assigned to the control group. Tics and comorbid symptoms were assessed pre- and post-intervention using the Yale Global Tic Severity Scale (YGTSS), Premonitory Urge for Tics Scale, attention-deficit hyperactivity disorder Rating Scale-IV, Children's Yale-Brown Obsessive-Compulsive Scale, and the Korean-Children Behavioral Checklist. We compared the pre- and post-intervention results of each group and determined the difference in the pre- and post-intervention results between intervention and the control group. Results: The YGTSS motor and vocal tic interference, global impairment, and global severity scores decreased in the intervention group only. Group CBIT was superior in reducing the motor tic interference, impairment score, and global severity score to the control group. Conclusion: The group-CBIT showed an improvement in tic symptoms, especially in reducing the level of interference and impairment of tics.

• Journal of Oriental Neuropsychiatry
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• v.20 no.1
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• pp.119-146
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• 2009

Objectives : In this study, patients with tic disorders who visited an Oriental medicine clinic were examined for their demographic characteristics, characteristics of symptoms, relation to Attention-deficit Hyperactivity Disorder(ADHD) and peculiarity according to various variables such as motor and vocal tics. Methods : After surveying 292 patients who visited an Oriental medicine clinic with tic symptoms as main complaints for 17 months, SAS 9.1, a statistical program was used for statistical analysis. Results : 1. The BMI of male tic patients was significantly higher than female ones and it was similar to or higher than the normal group. 2. Patients who are eldest children were 1.7 times higher than those who are not eldest ones. 3. The most usual case of motor tics was the eye blink and the most one of vocal tics was a dry cough. 4. There was no significant difference between male and female patients for all symptoms of motor and vocal tics, but male patients had significantly more obsessions related to tics than female ones. 5. There was no significant difference in the age of initial occurrence of Transient tic disorder(TTD), Chronic tic disoder(CTD) and Tourette's disorder(TD). 6. For the general disorder of a tic and Conners' ADHD rating scale, there was no significance in TTD, CTD and TD. 7. 66% out of the total subjects of 197 cases were found to score more than 65 points in more than 1 items among 8 items such as the time, hearing, wrong alarm, mean response time and standard deviation in the response time, etc. of the ADHD diagnosis system(ADS). 8. The eye blink among motor tics was shown mainly by patients under 10 years old and the frown, movement of the head, shrug and movement of the arms were shown mainly by 11-19 years old patients. Conclusions : For the number, frequency, seriousness and inconvenience in life of tics, TD showed a significantly higher result than TTD and CTD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.103-114
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• 2001

Tourette's disorder is a disease which manifests one or more motor tics and vocal tics for more than a year. Chronic motor tic or vocal tic disorders are characterized by only one kind of tics for more than a year. We intended to investigate the clinical characteristics of the patients with chronic motor tic disorders or Tourette's disorders who had admitted from May 1, 1998 to May 1, 1999 to Seoul National University Hospital Child and Adolescent Psychiatry ward. In addition, we compared the clinical characteristics of the patients in order to elucidate the relationship between the two disorders. The patients with learning disabilities were selected as controls. There was no statistically significant difference between the onsets of the patients with chronic motor tic disorders(n=13, $7.3{\pm}2.5$ years), and Tourette's disorder(n=39, $7.2{\pm}2.2$ years), but with learning disability($4.2{\pm}1.9$ years). Also, the patients with chronic motor tic disorder and Tourette's disorder showed similar age at admission($11.7{\pm}2.7$ versus $11.5{\pm}2.6$ years), duration of admission($5.7{\pm}5.4$ versus $11.0{\pm}8.7$ weeks), mothers' ages at child birth($27.3{\pm}2.9$ versus $28.3{\pm}6.7$ years old),and fathers' age at child birth($32.2{\pm}3.2$ versus $33.3{\pm}5.2$ years old). We observed that those who had learning disabilities were alike in those aspects, except for age at visit to clinic($9.8{\pm}3.2$ years old). Family history of psychiatric illnesses(24.1% versus 46.2%), recognized precipitating factors(11.1% versus 35.7%) and response to pharmacological treatments(77.8% versus 76.9%) of the patients with chronic motor tic disorders and Tourette's disorders were observed and no differences were found. Comorbid patterns of diseases were noted. Intrafamilial conflicts were more common in the patients with learning disabilities than those with chronic tic disorders or Tourette's disorders. Precipitating factors were observed more frequent in chronic tic disorder and Tourette's disorder than learning disability. Neurocognitive profiles were investigated, and verbal IQs of the patients with chronic motor tic disorder, Tourette's disorder and learning disability were $92.3{\pm}10.7$, $94.7{\pm}14.9$, $94.3{\pm}13.8$, performance IQs $93.0{\pm}20.5$, $97.5{\pm}13.0$, $95.0{\pm}16.9$ and full-scale IQs $91.9{\pm}20.1$, $95.8{\pm}14.5$, $93.9{\pm}15.1$, respectively, which were found to be not significantly different. No difference was found in structural neurological abnormalities and EEG profiles. The patients with learning disabilities showed more common Bender-Gestalt test abnormalities. In conclusion, we have not found any affirmative clues for the division of chronic motor tic disorder and Tourette's disorder in clinical perspective.

• Korean Journal of Psychosomatic Medicine
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• v.18 no.1
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• pp.3-10
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• 2010

Gilles de la Tourette syndrome is a chronic motor and vocal tic disorder of childhood onset. Abnornmalities in basal ganglia-thalamo-cortical circuits may play an important role in the pathophysiology underlying the involuntary tics. It is often complicated by comorbid attention-deficit/hyperactivity disorder or obsessive-compulsive disorder. Transcranial magnetic stimulation(TMS) is a neurophysiologic technique with research ap-plication. As there is good evidence that this technique can modify cortical activity, repetitive TMS is also used for treatment to change the cortical excitability and therefore affect underlying interconnected cortical-sub-cortical loop. We reviewed the neurophysiologic parameters and the clinical applicability of TMS and rTMS.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.1
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• pp.37-44
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• 2023

Objectives: Tic disorders are highly heritable; however, growing evidence suggests that environmental factors play a significant role in their pathogenesis. Studies on these factors have been inconsistent, with conflicting results. Therefore, this study aimed to examine the associations of pre- and perinatal exposure to Tourette syndrome (TS) or chronic tic disorders (CTD) in Korean school-aged children. Methods: This case-control study used data from a large prospective cohort study. The primary outcome was TS/CTD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria and Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version. Demographic, pre-, and perinatal information was obtained from the maternal questionnaires. Data between the TS/CTD and control groups were compared using the chi-squared or Student's t-test, as appropriate. Two-step logistic regression analyses were used to test the association between TS/CTD and pre- and perinatal risk factors. Results: We included of 223 children (78 with TS/CTD and 145 controls). Significant differences in the demographic data between the two groups were observed. The male sex ratio, mean parental age, parental final education level, and family history of tics were included as confounders. In the final adjusted multivariable model, TS/CTD was significantly associated with antiemetic exposure during pregnancy (odds ratio [OR]=16.61, 95% confidence interval [CI] 1.49-185.22, p=0.02) and medically assisted reproduction (OR=7.89, 95% CI 2.28-27.28, p=0.01). Conclusion: Antiemetic exposure and medically assisted reproduction are significantly associated with the risk of TS/CTD. These results should be replicated in future prospective and gene-by-environment studies.