Adult‐onset tic disorders

Abstract

We report on 8 patients with adult-onset motor tics and vocalisations. Three had compulsive tendencies in childhood and 3 had a family history of tics or obsessive-compulsive behaviour. In comparison with DSM-classified, younger-onset Gilles de la Tourette syndrome, adult-onset tic disorders are more often associated with severe symptoms, greater social morbidity, a potential trigger event, increased sensitivity, and poorer response to neuroleptic medication.

Adult‐Onset Primary Dystonic Tics: A Different Entity?

“…Concomitant psychiatric disorders were present in 5 patients (45.5%), of whom 3 developed their psychiatric symptoms after the tics onset, which is comparable to previous reports . However, whereas the most common psychiatric comorbidity in the 2 previous series was obsessive‐compulsive disorder, our patients reported mainly depression and anxiety . Furthermore, all the patients described by Eapen et al.…”

“…In a comparison of our patients to the series of adult‐onset tic disorders by Chouinard and Ford and Eapen et al., we note that the male/female ratio is similar (10:1 vs. 7:0 and 7:1, respectively), whereas our patients were older at tics onset (42 vs. 36.6 and 33.7 years, respectively). In both of these series, there was a positive family history for either psychiatric conditions or tics in approximately 50% of reported cases, whereas only 2 patients in our series (18.2%) reported a family history of neurological or psychiatric illnesses (depression and tremor).…”

“…Furthermore, all the patients described by Eapen et al. had a possible trigger event, including infections or drug exposure, which instead was not observed in our cases. The observed clinical differences between our series of adult‐onset dystonic tics and previous series of patients with adult‐onset tics led us to speculate that adult‐onset dystonic tics may represent a discrete entity that does not fall within the spectrum of TS.…”

Adult‐Onset Primary Dystonic Tics: A Different Entity?

“…Concomitant psychiatric disorders were present in 5 patients (45.5%), of whom 3 developed their psychiatric symptoms after the tics onset, which is comparable to previous reports . However, whereas the most common psychiatric comorbidity in the 2 previous series was obsessive‐compulsive disorder, our patients reported mainly depression and anxiety . Furthermore, all the patients described by Eapen et al.…”

“…In a comparison of our patients to the series of adult‐onset tic disorders by Chouinard and Ford and Eapen et al., we note that the male/female ratio is similar (10:1 vs. 7:0 and 7:1, respectively), whereas our patients were older at tics onset (42 vs. 36.6 and 33.7 years, respectively). In both of these series, there was a positive family history for either psychiatric conditions or tics in approximately 50% of reported cases, whereas only 2 patients in our series (18.2%) reported a family history of neurological or psychiatric illnesses (depression and tremor).…”

“…Furthermore, all the patients described by Eapen et al. had a possible trigger event, including infections or drug exposure, which instead was not observed in our cases. The observed clinical differences between our series of adult‐onset dystonic tics and previous series of patients with adult‐onset tics led us to speculate that adult‐onset dystonic tics may represent a discrete entity that does not fall within the spectrum of TS.…”

Axial jerks: a clinical spectrum ranging from propriospinal to psychogenic myoclonus

“…In our opinion, reported adult-onset tic disorders are rather atypical. For instance, Davies and colleagues reported a case of recumbent tics that is rather similar to some of our cases and its organic origin might be questioned [10, 11]. …”

Klazomania: A Rare Case of Compulsive Screaming, Complicating Major Depression, Effectively Treated with Electroconvulsive Therapy (ECT)

“…X had no remarkable symptom or history that required further work-up for ruling out unlikely causes for CS (poisoning, intellectual disability, neurodegenerative, infections). The compulsive screaming observed in this patient shares similar features observed in tic-like disorders [6], Klazomania [1,2], and typical depression with comorbid obsessive-compulsive traits [7]. Our patient's psychopathology was complicated by severe depression and an inability to control her episodes of paroxysmal shouting.…”

Adult‐Onset Primary Dystonic Tics: A Different Entity?

“…Concomitant psychiatric disorders were present in 5 patients (45.5%), of whom 3 developed their psychiatric symptoms after the tics onset, which is comparable to previous reports . However, whereas the most common psychiatric comorbidity in the 2 previous series was obsessive‐compulsive disorder, our patients reported mainly depression and anxiety . Furthermore, all the patients described by Eapen et al.…”

“…In a comparison of our patients to the series of adult‐onset tic disorders by Chouinard and Ford and Eapen et al., we note that the male/female ratio is similar (10:1 vs. 7:0 and 7:1, respectively), whereas our patients were older at tics onset (42 vs. 36.6 and 33.7 years, respectively). In both of these series, there was a positive family history for either psychiatric conditions or tics in approximately 50% of reported cases, whereas only 2 patients in our series (18.2%) reported a family history of neurological or psychiatric illnesses (depression and tremor).…”

“…Furthermore, all the patients described by Eapen et al. had a possible trigger event, including infections or drug exposure, which instead was not observed in our cases. The observed clinical differences between our series of adult‐onset dystonic tics and previous series of patients with adult‐onset tics led us to speculate that adult‐onset dystonic tics may represent a discrete entity that does not fall within the spectrum of TS.…”

Axial jerks: a clinical spectrum ranging from propriospinal to psychogenic myoclonus

“…In our opinion, reported adult-onset tic disorders are rather atypical. For instance, Davies and colleagues reported a case of recumbent tics that is rather similar to some of our cases and its organic origin might be questioned [10, 11]. …”

Klazomania: A Rare Case of Compulsive Screaming, Complicating Major Depression, Effectively Treated with Electroconvulsive Therapy (ECT)

“…X had no remarkable symptom or history that required further work-up for ruling out unlikely causes for CS (poisoning, intellectual disability, neurodegenerative, infections). The compulsive screaming observed in this patient shares similar features observed in tic-like disorders [6], Klazomania [1,2], and typical depression with comorbid obsessive-compulsive traits [7]. Our patient's psychopathology was complicated by severe depression and an inability to control her episodes of paroxysmal shouting.…”

Adult‐Onset Primary Dystonic Tics: A Different Entity?

“…Concomitant psychiatric disorders were present in 5 patients (45.5%), of whom 3 developed their psychiatric symptoms after the tics onset, which is comparable to previous reports . However, whereas the most common psychiatric comorbidity in the 2 previous series was obsessive‐compulsive disorder, our patients reported mainly depression and anxiety . Furthermore, all the patients described by Eapen et al.…”

“…In a comparison of our patients to the series of adult‐onset tic disorders by Chouinard and Ford and Eapen et al., we note that the male/female ratio is similar (10:1 vs. 7:0 and 7:1, respectively), whereas our patients were older at tics onset (42 vs. 36.6 and 33.7 years, respectively). In both of these series, there was a positive family history for either psychiatric conditions or tics in approximately 50% of reported cases, whereas only 2 patients in our series (18.2%) reported a family history of neurological or psychiatric illnesses (depression and tremor).…”

“…Furthermore, all the patients described by Eapen et al. had a possible trigger event, including infections or drug exposure, which instead was not observed in our cases. The observed clinical differences between our series of adult‐onset dystonic tics and previous series of patients with adult‐onset tics led us to speculate that adult‐onset dystonic tics may represent a discrete entity that does not fall within the spectrum of TS.…”

Axial jerks: a clinical spectrum ranging from propriospinal to psychogenic myoclonus

“…In our opinion, reported adult-onset tic disorders are rather atypical. For instance, Davies and colleagues reported a case of recumbent tics that is rather similar to some of our cases and its organic origin might be questioned [10, 11]. …”

Klazomania: A Rare Case of Compulsive Screaming, Complicating Major Depression, Effectively Treated with Electroconvulsive Therapy (ECT)

“…X had no remarkable symptom or history that required further work-up for ruling out unlikely causes for CS (poisoning, intellectual disability, neurodegenerative, infections). The compulsive screaming observed in this patient shares similar features observed in tic-like disorders [6], Klazomania [1,2], and typical depression with comorbid obsessive-compulsive traits [7]. Our patient's psychopathology was complicated by severe depression and an inability to control her episodes of paroxysmal shouting.…”