A 6-year-old boy presents with complaints of hyperactivity, excessive shoulder shrugging, throat clearing and eye blinking. During examination, he is not cooperative, uses obscene words and runs around in the consultation room. What is the most probable diagnosis?

Ans: A Attention deficit hyperactivity disorder with Tic disorder Ref: Nelson Textbook of Pediatrics, 19th edition. Pg 77 Explanation: The clinical vignette describes a classical case of Attention deficit hyperactivity disorder with= Tic disorder/ Tourette syndrome (Tic Disorder) Tics involve sudden, rapid, repetitive, involuntary movements of muscle groups or vocalizations and represent discharges of tension related to centra] nervous system electrochemical signals. Parts of the body that are most frequently involved are the muscles of the face, neck, shoulders, trunk and hands. Simple tics involve only 1 muscle group, as in eye blinking, shoulder shrugging or neck jerking, whereas complex ties may include multiple muscle groups and cause more complex motions. Simple vocalizations include grunting and throat clearing; complex vocalizations include the use of repetitive obscenities (coprolalia). Motor or vocal tics lasting <1 yr are transient; those lasting >1 yr are chronic, Tourette Syndrome It is characterized by a history of motor and vocal tics (may not present concurrently).