Beyond the ‘tic’ king clock: a case report on adult onset tic disorder

Tic is rapid recurrent non-rhythmic motor movement or vocalization; movement of limbs or other body parts is known as motor tic and involuntary repetitive sound like grunting sniffing throat clearing is known as a vocal tic. Tic is a neurodevelopmental disorder and has its onset in the developmental period. According to diagnostic and statistical manual of mental illnesses (DSM) 5, tic should have its onset before 18 years of age and can resolve with proper treatment. In this case, a 23-year-old female presented with recurrent abnormal throat clearing and excessive loud sounds which started for the last 1 year. Initially, she was diagnosed with psychogenic hiccup in another department and was treated with Baclofen 30 mg for 1 month but as no improvement was observed later she was referred to psychiatry outpatient department (OPD) for further treatment where she was diagnosed with adult onset vocal tic with a premonitory urge for tics scale (PUTS) score of 27 on admission and she was treated with tablet Risperidone 2 mg and after 4 weeks of treatment all symptoms subside and PUTS score came to be 6 at the time of discharge.