Patient Question: Disease: Pediatric Tourette’s DisorderDescription: I was diagnosed with pediatric Tourette’s on July 26, ’13 and have been taking medication since then, occasionally better and occasionally more powerful. Recently, I’ve been squeezing my eyes, I’ve been inattentive, I can’t concentrate on anything, I love to play pranks, I love to snicker, I love to hit people. Hope to help: whether to change the medication or to check again, whether it’s really a child’s tic Medication: Name of medication: aripiprazole, intelligence syrup, muscle liver Dosing instructions: 2013, 7-26 initial consultation started taking half a tablet once a day, after one month each time 1/3 tablet once a day :Syrup 3 sticks once a day once a day After December 30, aripiprazole was changed to l/4 tablets per day, and intelligence was changed to QingQingLing oral liquid until now Reply from Zhang Lulu, Department of Psychiatry, Guangzhou First People’s Hospital: We can combine the past developmental history of the child and improve the polysomnography and cranial CT and other related examinations to further investigate. Tic disorder is a complex, chronic neuropsychiatric disorder that begins in childhood and adolescence and is characterized by rapid, involuntary, sudden, repetitive, non-rhythmic, stereotyped, single or multi-site muscle motor twitching or (and) vocal twitching. According to the age of onset, course, clinical manifestations and the presence of vocal tics, there are three clinical types of transient tic disorder, chronic motor or vocal tic disorder, and Tourette syndrome. The first symptom is usually simple motor twitching, with the most frequent twitching of facial muscles, which is intermittent, and the first symptom of a few patients is simple vocal twitching. As the disease progresses, the number of twitching sites increases, gradually involving the shoulders, neck, limbs or trunk, and the manifestations develop from simple twitching to complex twitching, from single motor twitching or vocal twitching to both, and the frequency of occurrence also increases. If the child is clearly diagnosed with childhood tic disorder, he or she is treated with low-dose medication combined with psychotherapy. Due to the high side effects of traditional treatment medications for childhood tics, maintenance treatment with 1/4 tablet of aripiprazole may be continued and the dose may be increased to 1/2 tablet if necessary (depending on the child’s age and physical condition). If the treatment is not effective or the patient does not comply well, a switch to low-dose Depakene or Risperdal may be considered (these two drugs are available in oral solution for easy administration to the child). Because the central nervous system is not well developed in children, excessive use of central nervous system medications and sedative drugs is not recommended. In addition, psychological treatment should pay attention to the elimination of negative factors in the school and family environment that may have a role in the development or maintenance of the child’s symptoms, reduce the child’s anxiety and depression secondary to the tic symptoms, and improve the child’s social adjustment function. We wish the child a speedy recovery.