Advertisement

Tic Emergencies

  • Vanessa K. HinsonEmail author
  • Christopher G. GoetzEmail author
Chapter
Part of the Current Clinical Neurology book series (CCNEU)

Abstract

Tics are sudden involuntary stereotypic movements or sounds that emerge out of a normal background. The majority of patients with tic disorders either do not require pharmacological intervention or have a benign course of the tic disorder with appropriate treatment. In rare instances, tics are severe enough to cause a neurologic emergency. First, intense exacerbations may occur in the normal context of the waxing and waning course of tic disorders, sometimes exacerbated by medication or stress. Second, tics can cause secondary neurological impairment that may result in new disability, such as a case described here of sciatic nerve damage due to marked leg tics. Third, sudden and unusual tics can emerge in the context of acute neurological disorders other than Tourette Syndrome, and finally, the pharmacological treatment of tics can cause sudden adverse events in the form of tardive dyskinesia or akathisia. In this chapter, each of these tic emergencies is discussed, and the diagnosis and treatment are reviewed.

Keywords

Attention Deficit Hyperactivity Disorder Tourette Syndrome Botulinum Toxin Injection Compressive Neuropathy Choreic Movement 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Movement_Disorders_Emergencies_C16.mov (217,705 KB)

References

  1. 1.
    Leckman JF, Zhang H, Vitale A, et al. Course of tic severity in Tourette’s syndrome: the first two decades. Pediatrics. 1998;102:14–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Goetz CG, Tanner CM, Stebbins GT, et al. Adult tics in Gilles de la Tourette’s syndrome: description and risk factors. Neurology. 1992;42:784–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Rothenberger A, Kostanecka T, Kinkelbur J, Cohrs S, Woerner W, Hajak G. Sleep and Tourette syndrome. Adv Neurol. 2001;85:245–59.PubMedGoogle Scholar
  4. 4.
    Kompoliti K, Goetz CG, Leurgans S, et al. Estrogen, progesterone, and tic severity in women with Gilles de la Tourette syndrome. Neurology. 2001;57:1519.PubMedCrossRefGoogle Scholar
  5. 5.
    Erenberg G, Cruse RP, Rothner AD. Gilles de la Tourette’s syndrome: effect of stimulant drugs. Neurology. 1985;35:1346–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Price RA, Leckman JF, Pauls DL, et al. Gilles de la Tourette syndrome: tics and central nervous system stimulants in twins and non-twins. Neurology. 1986;36:232–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Shafii M. The effects of sympathomimetic and antihistaminic agents on chronic motor tics and Tourette’s disorder. N Engl J Med. 1986;315:1228–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Burd L, Kerbeshian J, Fisher W, Gascon G. Anticonvulsant medications: an iatrogenic cause of tic disorders. Can J Psychiatry. 1986;31:419–23.PubMedGoogle Scholar
  9. 9.
    Fras I. Gilles de la Tourette’s syndrome: effects of tricyclic antidepressants. N Y State J Med. 1978;78:1230–2.PubMedGoogle Scholar
  10. 10.
    Gatto E, Pikielny R, Micheli F. Fluoxetine in Tourette’s syndrome. Am J Psychiatry. 1994;151:946–7.PubMedGoogle Scholar
  11. 11.
    Mesulam M. Cocaine and Tourette’s syndrome. N Engl J Med. 1986;315:389.Google Scholar
  12. 12.
    Sallee FR, Nesbitt L, Jackson C, et al. Relative efficacy of haloperidol and pimozide in children and adolescents with Tourette’s disorder. Am J Psychiatry. 1997;154:1057–62.PubMedGoogle Scholar
  13. 13.
    Lyon GJ, Samar S, Jummani R, et al. Aripiprazole in children and adolescents with Tourette disorder with and without explosive outbursts. J Child Adolesc Psychopharmacol. 2009;19:623–33.PubMedCrossRefGoogle Scholar
  14. 14.
    Kenney C, Hunter CB, Mejia NI, Jankovic J. Tetrabenazine in the treatment of Tourette syndrome. J Pediatr Neurol. 2007;5:9–13.Google Scholar
  15. 15.
    Jankovic J. Botulinum toxin in the treatment of dystonic tics. Mov Disord. 1994;9:347–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Marras C, Andrews D, Sime E, Lang AE. Botulinum toxin for simple motor tics: a randomized, double blind, controlled clinical trial. Neurology. 2001;56:605–10.PubMedCrossRefGoogle Scholar
  17. 17.
    Scott BL, Jankovic J, Donovan DT. Botulinum toxin injection into vocal cord in the treatment of malignant coprolalia associated with Tourette’s syndrome. Mov Disord. 1996;11:431–3.PubMedCrossRefGoogle Scholar
  18. 18.
    Salloway S, Stewart CF, Israeli L, et al. Botulinum toxin for refractory vocal tics. Mov Disord. 1996;11:746–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Goetz CG, Klawans HL. Gilles de la Tourette syndrome and compressive neuropathies. Ann Neurol. 1980;8:453.PubMedCrossRefGoogle Scholar
  20. 20.
    Krauss JK, Jankovic J. Severe motor tics causing cervical myelopathy in Tourette’s syndrome. Mov Disord. 1996;11:563–6.PubMedCrossRefGoogle Scholar
  21. 21.
    Riley DE, Lang AE. Pain in Gilles de la Tourette Syndrome and related tic disorders. Can J Neurol Sci. 1989;16:439–41.PubMedGoogle Scholar
  22. 22.
    Kumar R, Lang AE. Secondary tic disorders. Neurol Clin. 1997;15:309–31.PubMedCrossRefGoogle Scholar
  23. 23.
    von Economo C. Encephalitis lethargica: its sequelae and treatment. London: Oxford University Press; 1931.Google Scholar
  24. 24.
    Turley JM. Tourette-like disorder after herpes simplex encephalitis. Am J Psychiatry. 1988;145:1604–5.PubMedGoogle Scholar
  25. 25.
    Northam RS, Singer HS. Postencephalitic Tourette-like syndrome in a child. Neurology. 1991;4:592–3.CrossRefGoogle Scholar
  26. 26.
    MCDaniel JS, Summerville MB. Tic disorder associated with encephalopathy in advanced HIV disease. Gen Hosp Psychiatry. 1974;125:593–4.Google Scholar
  27. 27.
    Behan P, Geschwind N, Quadfase FA. Coprolalia in Sydenham’s chorea. Abstract. First International Gilles de la Tourette Syndrome Meeting, New York; 1981.Google Scholar
  28. 28.
    Lees AJ. Tics occurring in association with neurological disorders. In: Lees AJ, editor. Tics and related disorders. New York: Churchill Livingstone; 1985. p. 70–82.Google Scholar
  29. 29.
    Swedo SE. Sydenham’s chorea: a model for childhood autoimmune psychiatric disorders. JAMA. 1994;272:1788–91.PubMedCrossRefGoogle Scholar
  30. 30.
    Pulst S, Walshe TM, Romero JA. Carbon monoxide poisoning with features of Gilles de la Tourette’s Syndrome. Arch Neurol. 1983;40:443–4.PubMedCrossRefGoogle Scholar
  31. 31.
    Sacks OW. Tourettism in strokes. Tourette Syndrome Association Newsletter. 1980;(VII:4:7).Google Scholar
  32. 32.
    Jankovic J. Tics in other neurologic disorders. In: Kurlan R, editor. Handbook of Tourette’s syndrome and related tic and behavioral disorders. New York: Marcell Dekker, Inc; 1993. p. 167–82.Google Scholar
  33. 33.
    Krauss JK, Jankovic J. Tics secondary to craniocerebral trauma. Mov Disord. 1997;12:776–82.PubMedCrossRefGoogle Scholar
  34. 34.
    Kompoliti K, Goetz CG. Hyperkinetic movement disorders misdiagnosed as tics in Gilles de la Tourette Syndrome. Mov Disord. 1998;13:477–80.PubMedCrossRefGoogle Scholar
  35. 35.
    Bruun RD. Subtle and underrecognized side effects of neuroleptic treatment in children with Tourette’s disorder. Am J Psychiatry. 1988;145:621–4.PubMedGoogle Scholar
  36. 36.
    Shapiro E, Shapiro AK. Tardive dyskinesia and chronic neuroleptic treatment of Tourette patients. Adv Neurol. 1982;35:413.PubMedGoogle Scholar
  37. 37.
    Lang A. Patient perception of tics and other movement disorders. Neurology. 1991;41:223–8.PubMedCrossRefGoogle Scholar
  38. 38.
    Ondo WG, Hanna PA, Jankovic J. Tetrabenazine treatment for tardive dyskinesia: assessment by randomized videotape protocol. Am J Psychiatry. 1999;156:1279–81.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of NeurosciencesMedical University of South CaroloinaCharlestonUSA
  2. 2.Department of Neurological Sciences, Department of PharmacologyRush University Medical CenterChicagoUSA

Personalised recommendations