A 11 year old boy is brought for a psychiatric evaluation. The mother gives a history of patient’s complains which started one and half year ago. He has repeated episodes of abrupt vocalisations and whistling which disrupts his normal activities in school. The symptoms also include repeated shoulder shrugging, blinking and sniffing. The child used to take part in music classes, but since one year he has been unable to do the same. He was born out of a non consanguineous marriage through normal vaginal delivery.
His developmental and growth history are normal for age. He has no history of any significant medical or surgical treatment. No similar history is present in any other family member. Examination showed normal thought processing and higher mental functions. Motor tics, grunting and nasal sniffing were present during the examination. Investigations were all normal including a CT…
