Star Athlete With a Blinking Fixation Struggling in College

Claudia L. Reardon, MD


December 29, 2021

Ocular tics are probably the most common motor tics. Given their long-standing presence in this patient, an apparently similar childhood phenomenon in his father (and no seemingly dire outcome of his father's condition after many years), and the association with OCD and ADHD, motor tics are the most probable explanation here. Of note, some of the most common kinds of tics, such as ocular manifestations and coughing, are often confused with allergies, asthma, and vision problems. Thus, pediatricians, allergists, and ophthalmologists are not uncommonly among the first to identify tics in children.[11]

For this patient, immediate steps taken at the time of the first appointment were to obtain his written permission to contact his parents for the purposes of obtaining collateral information on historical symptoms, family history, and academic functioning. He was also referred for neuropsychological testing to assess for a possible component of ADHD. Finally, a plan was made to start psychotherapy, and medication options were considered as additional diagnostic information became available.


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