Journal of Pediatric Neurology
DOI: 10.1055/s-0040-1718696
Case Report

Cervical Myelopathy as a Complication of Untreated Motor Tics: A Cautionary Tale

Mariam Hull
1  Section of Pediatric Neurology and Developmental Neuroscience, Pediatric Movement Disorders Clinic, Blue Bird Circle Clinic for Pediatric Neurology, Texas Children's Hospital | Baylor College of Medicine, Houston, Texas, United States
,
Mered Parnes
1  Section of Pediatric Neurology and Developmental Neuroscience, Pediatric Movement Disorders Clinic, Blue Bird Circle Clinic for Pediatric Neurology, Texas Children's Hospital | Baylor College of Medicine, Houston, Texas, United States
› Author Affiliations
Funding None.

Abstract

Tic disorders are common, affecting approximately 0.5 to 1% of children and adolescents. Treatment is required only when symptoms are bothersome or impairing to the patient, so many do not require intervention. However, on occasion tics may cause significant morbidity and are referred to as “malignant.” These malignant tics have resulted in cervical myelopathy, subdural hematoma secondary to head banging, biting of lips leading to infection of oral muscles, self-inflicted eye injuries leading to blindness, skeletal fractures, compressive neuropathies, and vertebral artery dissection. We describe a case of malignant tic disorder, with accompanying video segment, resulting in cervical myelopathy and quadriparesis in a child. We also discuss aggressive management strategies for neurologists to prevent potential lifelong disability. This case emphasizes that these malignant tics must be treated with all due haste to prevent such complications.



Publication History

Received: 31 August 2020

Accepted: 11 September 2020

Publication Date:
26 October 2020 (online)

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