Dr. Jyotismita Choudhury (Psychiatry) needs a second opinion on this medical case.
A 30 year old male presented with complaints of sudden repetitive movements of shoulders and repetitive barking like sounds from 10years of age,excessive worrying over trivial issues accompanied by fearfulness and difficultly in breathing in crucial sitiations lasting for few mins to hours for over 2 years now,sleep disturbance,difficulty in erection while having sex with wife with decrease libido for around 6 months now...patient mentions there is no erectile problems during masturbation...on examination--motor tics and vocal tics present...on MSE..mood is anxious with somatic preoccupatio...i diagnsed this case as TOURETTE SYNDROME(childhood onset)with GAD with sexual dysfunction secondary to anxiety...HOW SHOULD I APPROACH THIS PATIENT? please suggest...
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