Thread by @hyderabaddoctor

A teenager whose unusual #disease forced him to live a #lonely life

1. Sam was a bubbly kid until the age of 8, when his parents noted that he would blink his eyes on an off. This did not trouble Sam, however, he was taken for an eye check up, which didn't show any abnormality.

2. Two years later, he started shrugging his shoulder and would occasionally hop on one leg. This would repeat 5-6 times in a day. Sam had no control on these movements. Again, this did not bother Sam but his parents were perturbed. They thought Sam is being naughty.
#MedTwitter

3. By age 12, Sam started to make some unusual sounds, as if he is clearing his throat or grunting. Sam had no control on these sounds too.
His friends had started making fun of him. He could suppress them for a few minutes, however, after that, movements & sounds would return.

4. His teachers were not pleased and complained to his parents that Sam was "intentionally" disturbing others in the class and that he had become a "nuisance" for everyone else.
Sam started looking for excuses to bunk school, even though he was a bright student.
#neurotwitter

5. He had no solace at home too.
Sam was taken to a few general physicians, who didn't find anything wrong.
His parents thought he was intentionally producing those funny sounds & those awkward movements, and often scolded him to mend his ways.
Sam was unable to convince them.

6. He had become a source of joke among his friends, who would often mock & tease him for his unusual sounds and hopping movements.
All these forced Sam into a state of depression and he felt lonely. He would often sit alone in the corner of park and gaze into the sky for hours.

7. This took a toll on his studies and his performance at school declined.
At this stage, his parent brought him for my consultation to find ways to improve his 'memory".
Sam was 14-year old now. While talking to his parents, I was constantly observing Sam.

8. Sam was blinking his eyes, shrugging his shoulders and making sounds as if he is clearing his throat. In 15 minutes, it happened 12-15 times. Anxiety, was perhaps, making it worse.
I had made my diagnosis by then. I felt sorry for his past few years but his future had "hope".

9. He was suffering from #Tourette syndrome (#tic disorder), which is a brain disorder (possibly due to neuro-transmitter imbalance).
I started him on oral medications.
A month later, he was better by 50%. Dose was adjusted and subsequently he had 90% relief from symptoms.

10. He was able to focus well in his studies.
His self-confidence improved.
He was a good basketball player and was selected for his school team too.
He was back to having fun with his friends.
His life had transformed 360 degrees (from negativity to positivity).

1. Take home message
In a child or teenager, abnormal involuntary blinking of eyes, shoulder shrugs, neck movements & hopping could be suggestive of motor tics.
Involuntary grunting or throat clearing sounds could be vocal tics.
Tic disorder can be well managed with medicines.