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Old 09-06-2012
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Arrow Gyrus Daily Questions; Pediatrics #9

A 10-year-old boy has been having episodes of repetitive and semipurposeful movements of the face and shoulders. The parents believe these movements are worse when the child is under emotional stress. They also volunteer that they have never noted the movements while the patient is asleep. The movements have been present for more than 6 months. The parents are now especially concerned because the child has developed repetitive episodes of throat clearing and snorting. Physical and neurologic examinations are entirely normal. During the examination you note that the child has some blinking of the right eye, twitching of the right face, and grimacing. You ask him to stop these movements, and he is temporarily successful in doing so, but the movements recur. The home situation, social history, and child’s development and social adjustment appear normal. A head CT scan is normal. Of the following, which would be the most appropriate next step?

(A) order an electroencephalogram
(B) prescribe carbamazepine
(C) prescribe corticosteroids
(D) prescribe haloperidol
(E) refer the child to a psychiatrist
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Old 09-06-2012
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This little fella has Tourette's syndrome, drugs of choice include atypical antipsychotics....
Referral is never right

Seeing that risperidone is not in the options then Haloperidol would be the next logical answer because it also blocks D2 receptors
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Old 09-06-2012
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Yes its Tics -- Tourette syndrome - Rx is Haloperidol.
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