Symptomatic (secondary) tic syndromes

Ivan Donaldson, C. David Marsden, Susanne A. Schneider and Kailash P. Bhatia

in Marsden's Book of Movement Disorders

Published on behalf of Oxford University Press

ISBN: 9780192619112
Published online January 2012 | e-ISBN: 9780199698103 | DOI:
Symptomatic (secondary) tic syndromes

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Disorders causing secondary tics can be divided into congenital and acquired types. The former include dominantly and recessively inherited neurological disorders in which tic occasionally occurs. Many older descriptions refer to tic-like movements in conditions that are now recognized as primarily choreic, dystonic, myoclonic, and the like. If vocalizations occurred in such conditions there was the temptation to describe them as examples of secondary tics. Even in more recent literature confusion exists (Weingarten 1968). Thus, although tic has occasionally been reported in Huntington’s disease, generalized idiopathic torsion dystonia, and so forth, they are not further elaborated here. In choreoacanthocytosis some cases have both motor and vocal tics in addition to other involuntary movements. In addition, there is evidence to suggest that obsessive-compulsive behaviour, which is commonly seen in Gilles de la Tourette’s syndrome, can occur secondary to pathology involving the basal ganglia or frontal lobes (Laplane et al. 1984, Ward 1988, Williams et al. 1988, Laplane et al. 1989, Rapoport 1990). Mejia and Jankovic (1995) investigated this aspect and found that similar to Tourette’s syndrome, about half of the patients with secondary tics had obsessive-compulsive features. However, in contrast to Tourette’s syndrome only a minority had attention deficit (present in one third of patients), behavioural (present in one fifth of patients), or sleep (present in only 5 % of patients) problems. As discussed in Chapter 27, distinguishing between such behaviour and complex tics is not easy and the dividing line is somewhat arbitrary. None-the-less, obsessive-compulsive behaviour unaccompanied by other evidence of tics is not further considered in this chapter.

Chapter.  6746 words. 

Subjects: Neurology

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