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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Facial Grimaces With Clenching Of Teeth In A Child?

my 12 year daughter is having tics for some time and now they have progressed to facial grimaces with teeth clenched and back arches and stiffening. her ceruloplasmin levels have come at 20.1 and 18.6 in two tests. she has no KF rings in the eye, liver function is normal. doctor has asked to do copper serum test as wel as the 24 hour urine copper test. hile we await he has asked to start her on tab sizodon and arkamine. should we do that before we evn know what she has? first he said tourettes syndrome and now it could be wilson disease. should we not first onfirm what this is first. also her atacks ar so like extreme seizures without any fainting. very stressed
Tue, 6 Oct 2015
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Pediatrician, Neonatology,  's  Response
Naturally you will be stressed ,because the conditions that your doctor has mentioned are rare inherited disorders ----and the fact that your ceruloplasmin level is within normal range unlikely to be Wilsons disease .If your daughter had tics and stiffeneing ,does she have abnormal sounds and uttering words repeatedly.I suggest that you visit a pediatric neurologist .If it is tourette syndrome which is a neurotransmitter disorder ,and the medications are meant for that ,very good supervision is necessary at the start.you will have to have a group to manage your childs needs .including tick management ,behavioural management ,social support and so on .Yes you are right ,You have to confirm your diagnosis before starting treatmnet and the management has to be comprehensive and multi faceted instead of single medication therapies.
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What Causes Facial Grimaces With Clenching Of Teeth In A Child?

Naturally you will be stressed ,because the conditions that your doctor has mentioned are rare inherited disorders ----and the fact that your ceruloplasmin level is within normal range unlikely to be Wilsons disease .If your daughter had tics and stiffeneing ,does she have abnormal sounds and uttering words repeatedly.I suggest that you visit a pediatric neurologist .If it is tourette syndrome which is a neurotransmitter disorder ,and the medications are meant for that ,very good supervision is necessary at the start.you will have to have a group to manage your childs needs .including tick management ,behavioural management ,social support and so on .Yes you are right ,You have to confirm your diagnosis before starting treatmnet and the management has to be comprehensive and multi faceted instead of single medication therapies.