Tic Exacerbation in Adults with Tourette Syndrome: A Case Series

Tremor and Other Hyperkinetic Movements

article

Sara M. Schaefer¹  Christopher A. Chow¹  Elan D. Louis¹  Daphne Robakis¹ 

[1] Department of Neurology, Yale School of Medicine, Yale University;Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University;Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University

关键词: Tics;    Tourette syndrome;   

DOI  :  10.5334/tohm.339

学科分类：社会科学、人文和艺术（综合）

来源: Ubiquity Press

【 摘 要 】

Background: Tourette syndrome (TS) has been described as peaking in adolescence with subsequent regression. We report patients who were diagnosed with TS during childhood who experienced a latent period (significant reduction in or absence of tics) followed by tic re-emergence in adulthood. Methods: We performed a retrospective chart review of outpatients over age 21 seen at the Yale neurology clinic between January 2012 and July 2016 who were diagnosed with childhood-onset tics, and who experienced a latent period of greater than 1 year followed by an exacerbation. Results: Sixteen patients were identified. The mean latent period was 16 years. Ten patients (62.5%) identified an exacerbation trigger, most commonly changes in substance use (five patients). Seven patients (43.8%) reported worsening of tics since childhood. Six patients (37.5%) had received pharmacological intervention for tics as children, and 15 patients (93.8%) as adults. Six of 15 patients (40.0%) had an effective response from those pharmacological intervention(s). Discussion: Our study demonstrates that the decline in symptoms as patients age may represent temporary improvement. The latent period lasted years in our patients, different from the more rapid waxing and waning in children. A change in substance use was an important trigger. Requests for pharmacological intervention were not necessarily correlated with worsening tic severity.

【 授权许可】

CC BY