COMBINED MULTIPLE MOTOR AND VOCAL TIC DISORDER
\kəmbˈa͡ɪnd mˈʌltɪpə͡l mˈə͡ʊtə and vˈə͡ʊkə͡l tˈɪk dɪsˈɔːdə], \kəmbˈaɪnd mˈʌltɪpəl mˈəʊtə and vˈəʊkəl tˈɪk dɪsˈɔːdə], \k_ə_m_b_ˈaɪ_n_d m_ˈʌ_l_t_ɪ_p_əl m_ˈəʊ_t_ə__ a_n_d v_ˈəʊ_k_əl t_ˈɪ_k d_ɪ_s_ˈɔː_d_ə]\
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A neuropsychological disorder related to alterations in dopamine metabolism and neurotransmission involving frontal-subcortical neuronal circuits. Both multiple motor and one or more vocal tics need to be present with TICS occurring many times a day, nearly daily, over a period of more than one year. The onset is before age 18 and the disturbance is not due to direct physiological effects of a substance or a general medical condition. The disturbance causes marked distress or significant impairment in social, occupational, or other important areas of functioning. (From DSM-IV, 1994; Neurol Clin 1997 May;15 (2):357-79)
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