The patient, a Caucasian male diagnosed with KFS, was referred at age of 9 years for evaluation of repetitive movements. He presented with motor stereotypy in the 1st year of life which persists to the present: a patterned movement involving the flapping of both hands, and sometimes body and leg stiffening is occurring daily, with excitement. From age 6 to his present age, 12 years, he has had a series of mild tics including eye blinking, nose twitching, leg and toe pointing, and repetitive coughing and sniffing, consistent with a diagnosis of TS. He also has obsessive compulsive behaviour (OCB) and anxiety, with excessive rumination, but no Attention Deficit Hyperactivity Disorder (ADHD). He has seen a psychologist for dysthymia and adjustment but takes no neurologic or psychiatric medications. At school, academic performance is average to above. Past Medical History includes full-term birth, at 3.1 kg. Development includes walking by 16 months and speaking normally by 2 years. Surgical history includes a Woodward Procedure for Sprengel's Deformity of the scapula and Cervical Spine Decompression and Stabilization. Review of systems includes parasomnias and migraines. Family history is negative for tics, OCB, or other neurologic or psychiatric disorders.
