Movement Disorders (revue)

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Malignant Tourette syndrome

Identifieur interne : 002D56 ( Main/Exploration ); précédent : 002D55; suivant : 002D57

Malignant Tourette syndrome

Auteurs : Min-Yuen Cynthia Cheung [États-Unis] ; Joohi Shahed [États-Unis] ; Joseph Jankovic [États-Unis]

Source :

RBID : ISTEX:D9A0329634F884A9B269897A165E37AA92430393

Descripteurs français

English descriptors

Abstract

The aim of this work was to draw attention to potentially life‐threatening symptoms associated with Tourette syndrome (TS) and to explore their relationship to TS comorbidities. Medical records of all patients with TS evaluated at our Movement Disorders Clinic between July 2003 and July 2006 were reviewed. Data on patients with malignant TS, defined as ≥2 emergency room (ER) visits or ≥1 hospitalizations for TS symptoms or its associated behavioral comorbidities, were entered into a dataset and analyzed. Five illustrative cases are described. Of 333 TS patients evaluated during the 3‐year period, 17 (5.1%) met the criteria for malignant TS. Hospital admission or ER visits were for tic‐related injuries, self‐injurious behavior (SIB), uncontrollable violence and temper, and suicidal ideation/attempts. Compared with patients with nonmalignant TS, those with malignant TS were significantly more likely to have a personal history of obsessive compulsive behavior/disorder (OCB/OCD), complex phonic tics, coprolalia, copropraxia, SIB, mood disorder, suicidal ideation, and poor response to medications. Although TS is rarely a disabling disorder, about 5% of patients referred to a specialty clinic have life‐threatening symptoms. Malignant TS is associated with greater severity of motor symptoms and the presence of ≥2 behavioral comorbidities. OCD/OCB in particular may play a central role in malignant TS; obsessive compulsive qualities were associated with life‐threatening tics, SIB, and suicidal ideation. Malignant TS is more refractory to medical treatment than nonmalignant TS. © 2007 Movement Disorder Society

Url:
DOI: 10.1002/mds.21599


Affiliations:


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