Alberto J. Espay, MD, MSc, FAAN
CONTINUUM: Lifelong Learning in Neurology. 19(5, Movement Disorders):1287-1311, October 2013
A 17-year-old boy with a history of vocalizations and arm flailing, which started at 6 years of age, followed by multiple tics, including wrist flexion, feet cracking, throat clearing, shoulder popping, and neck jerking. After a fluctuating course with an almost quiescent 2-year period, neck jerking resurfaced. The movements caused degenerative disc disease and pain. Treatment with aripiprazole helped, but the movements still caused disruption at school and made driving less safe.