1/35. Late onset startle induced tics. Three cases of late onset Gilles de la Tourette's syndrome are presented. The motor tics were mainly induced by an unexpected startling stimulus, but the startle reflex was not exaggerated. The tics developed after physical trauma or a period of undue emotional stress. reflex tics may occur in Gilles de la Tourette's syndrome, but have not been described in late onset Tourette's syndrome. Such tics must be distinguished from psychogenic myoclonus and the culture bound startle syndromes. ( info) |
2/35. An unusual presentation of Tourette's syndrome. STUDY OBJECTIVE: To report an unusual complex motor tic as the presenting symptom in a patient diagnosed with Tourette's syndrome. methods: This case report was compiled via interview with a 9-year-old white female who presented to the private gynecologic practice of the senior author. Additional history was gained from the patient's mother and follow up information was obtained from written and verbal communication with neurology colleagues. MAIN OUTCOME MEASURES: Referral to neurology. diagnosis of persistent perineal touching. RESULTS: diagnosis of Tourette's syndrome. CONCLUSION: In young patients with nonspecific vulval symptoms, Tourette's syndrome should be considered in the differential diagnosis particularly if persistent self touching is a feature of the complaint. Referral to a physician experienced with the syndrome is important since the diagnosis is made on the basis of the clinical symptoms and signs. ( info) |
3/35. Occurrence of tics in Asperger's syndrome and autistic disorder. Asperger's syndrome is a condition in the autistic spectrum in which language development is normal. patients with Asperger's syndrome frequently exhibit repetitive movements (stereotypies), and can have motor and phonic tics in addition to other behavioral abnormalities. We present 12 patients with autistic spectrum disorders who were referred to our movement disorders Clinic for evaluation of tics. Eight of the 12 had normal language development and therefore met criteria for Asperger's syndrome. All patients exhibited stereotypic movements; in addition, seven had tics and six of these met diagnostic criteria for tourette syndrome. Of the six patients with clinical features of both Asperger's syndrome and tourette syndrome, three had severe congenital sensory deficits. The autistic patients in our series were clinically heterogeneous and though tics were clearly present, other aberrant movements demonstrated by them were harder to classify. Our series confirms the wide range of clinical manifestations in Asperger's syndrome and autism, including tics and other features of tourette syndrome. Furthermore, it suggests that sensory deprivation contributes to the development of adventitious movements in this population. ( info) |
4/35. Lamotrigine-induced tic disorder: report of five pediatric cases. PURPOSE: To describe the clinical spectrum of lamotrigine (LTG)-induced tics (an uncommon side effect) in children. methods: Retrospective analysis of patients from our hospital-based practice who developed tics while on LTG. Data obtained from medical records, interviews with parents, video-EEGs, and homemade videotapes. RESULTS: Three males and two females (range, 2.5-12 years; mean, 6.9 years) developed a movement disorder within the first 10 months of therapy (maintenance doses, 4-17 mg/kg/day). Four patients exhibited simple motor tics; one patient experienced mostly vocal (i.e., gasping sounds) tics. Laryngoscopic evaluation of one 2.5-year-old with repetitive gasping sounds was normal. In three cases, tics resolved completely within 1 month of drug cessation; tics recurred in two of these patients after reintroduction of LTG. A fourth patient experienced gradual improvement after stopping LTG over 4 months; the fifth patient's simple motor tics improved spontaneously with a reduction in medication. None of the patients had clinical features of a neurodegenerative disorder, and none met diagnostic criteria for tourette syndrome. Two patients, however, had a diagnosis of acquired epileptic aphasia syndrome, and one patient had nonprogressive expressive and receptive language dysfunction. A fourth patient had global static encephalopathy, and the fifth patient had only attentional problems. In all patients, tics were not associated with ictal EEG changes. CONCLUSIONS: LTG may infrequently induce simple motor tics, vocal tics, or both. patients with severe language dysfunction may be particularly susceptible to this uncommon side effect. Further studies are necessary to clarify the population at risk. ( info) |
5/35. mercury intoxication presenting with tics. A 5 year old Chinese boy presented with recurrent oral ulceration followed by motor and vocal tics. The Chinese herbal spray he used for his mouth ulcers was found to have a high mercury content. His blood mercury concentration was raised. Isolated tics as the sole presentation of mercury intoxication has not previously been reported. ( info) |
6/35. Dysfluency and phonic tics in tourette syndrome: a case report. tourette syndrome, a condition first recognized in 1825, is characterized by the presence of multiple motor tics and one or more phonic tics. Individuals with tourette syndrome may also demonstrate fluency failures in their speech. This study investigated the disfluencies and phonic tics in an 18-year-old affected male before and after a three week period of speech therapy. It was found that the speech pattern displayed by this subject did not completely conform to the classic pattern of stuttering but did bear more resemblance to cluttering. A limited number of therapy sessions resulted in a significant improvement of speech. ( info) |
7/35. carbamazepine-induced combined phonic and motor tic in a boy with Down's syndrome. We report the occurrence of a tic in a boy with Down's syndrome. The movement disorder was induced by carbamazepine (CBZ) and resolved completely after discontinuation of CBZ. The development of tics seems to be a rare, idiosyncratic side effect of CBZ in children. ( info) |
8/35. Asperger's syndrome, X-linked mental retardation (MRX23), and chronic vocal tic disorder. Pervasive developmental disorders are severe disorders of development with no consistent neurobiologic etiology and most often an idiopathic etiology. We report a 12-year-old male who met criteria for a pervasive developmental disorder (Asperger's syndrome) and a chronic tic disorder. The child also has an X-linked cognitive impairment (MRX23). The presence of tic symptomatology, pervasive developmental disorder, and fragile x syndrome has previously been reported. Since no singular etiology for Asperger's syndrome has been found, the possibility of other cases of Asperger's syndrome occurring with concurrent abnormalities on the x chromosome should be considered by clinicians, especially if tic symptomatology is present. ( info) |
| clonidine usually serves as a tic-suppressing agent in patients with tourette syndrome. A case study is presented in which clonidine at subclinical concentrations led to an exacerbation of the tics and caused severe systemic heat sensations. Involvement of functional abnormalities of the hypothalamus in tourette syndrome is hypothesized. ( info) |
10/35. Analyzing the influence of tic-related talk on vocal and motor tics in children with Tourette's syndrome. This study examined the effect of tic-related talk on the vocal and motor tics of 2 boys with Tourette's syndrome. Using ABAB withdrawal designs, the boys were alternately exposed to conditions with and without talk of their tics. For both boys, vocal tics markedly increased when talk pertained to tics and decreased when talk did not pertain to tics, but motor tic covariance was less consistent. ( info) |