<s>[INST] 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 [/INST] 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 Wilson's disease. If your daughter had tics and stiffening, does she have abnormal sounds and uttering words repeatedly. I suggest that you visit a pediatric neurologist. If it is Tourette syn Chat Doctor. You will have to have a group to manage your children needs.including tick management, behavioral management, social support and so on. Yes you are right, You have to confirm your diagnosis before starting treatment and the management has to be comprehensive and multi faceted instead of single medication therapies. </s>