Highlights
- •Adult-onset tics are rare, occurring either de novo or with previously unrecognised childhood tics.
- •Head trauma is an infrequent precipitant of tics, which vary in their temporal course and outcome.
- •We present a patient who developed late-onset tics after a strikingly focal brain injury.
- •A review of all previously reported post-traumatic tics is provided.
- •We discuss tics secondary to focal brain lesions, and their possible anatomical substrates.
Abstract
Adult-onset tics represent either a secondary tic disorder (“tourettism”) or a late
presentation of childhood tics, which may have been previously unrecognised. Head
trauma has been recognised as an infrequent cause of adult-onset tic disorder, which
exhibits variable temporal relationship to the inciting injury and response to therapy.
We present a patient who presented with late-onset tics seven years after a circumscribed
brain injury, responding well to antidopaminergic treatment. A review of all the previously
reported cases of post-traumatic tic disorder is provided. Our patient is unusual
in that the injury presumed to be responsible for the development of tics was of a
very focal nature, akin to previously described tic disorder following vascular insults.
We discuss the rare occurrence of tourettism after such focal brain lesions and analyse
the insights this provides into the anatomical substrates underlying tic disorders.
Keywords
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Article info
Publication history
Published online: March 13, 2020
Accepted:
March 8,
2020
Received:
December 13,
2019
Identification
Copyright
Crown Copyright © 2020 Published by Elsevier Ltd. All rights reserved.
