CC BY-NC-ND 4.0 · Neuropediatrics 2021; 52(05): 370-376
DOI: 10.1055/s-0040-1722689
Original Article

Tonic Tics in Gilles de la Tourette Syndrome

Justyna Kaczyńska
1   Department of Neurology, Medical University of Warsaw, Warsaw, Poland
,
Piotr Janik
1   Department of Neurology, Medical University of Warsaw, Warsaw, Poland
› Author Affiliations

Abstract

Aim Tonic tics (TTs) are a part of a clinical picture of Gilles de la Tourette syndrome (GTS) and manifest themselves as sustained and isometric contraction of a muscle group devoid of the movement effect or accompanied by only slight visible motion. The aim of this study was to evaluate the prevalence and phenomenology of TTs, and to assess the clinical associations of TTs with tic severity and comorbidities in patients with GTS.

Methods We performed a one-time registration study in a cohort of 241 consecutive outpatients with GTS aged 5 to 50 years (188 males, 153 patients under the age of 18 years). All patients were personally interviewed and examined.

Results TTs occurred in 85.2% of adults and 63.9% of children and adolescents. Most frequently reported types of TTs were tensing of the abdomen (58.7%), neck (52.7%), and upper limbs (50.3%). Multivariate statistical analysis showed a significant correlation between TTs and the total number of simple tics, total number of complex tics, and age at evaluation. In the group of children and adolescents, an additional significant variable was the duration of GTS. In the group of adults, significant parameters were total number of simple tics, total number of complex tics, peak tic severity ever experienced, premonitory urges, and the presence of dystonic tics.

Conclusion TTs belong to the tic spectrum, common and early symptoms of GTS, are associated with overall a greater number of tics which are more severe, and with more comorbidities.



Publication History

Received: 26 March 2020

Accepted: 09 October 2020

Article published online:
14 January 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Singer HS. Tics and Tourette syndrome. Continuum (Minneap Minn) 2019; 25 (04) 936-958
  • 2 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed.. Washington: American Psychiatric Association; 2013
  • 3 Martino D, Madhusudan N, Zis P, Cavanna AE. An introduction to the clinical phenomenology of Tourette syndrome. Int Rev Neurobiol 2013; 112: 1-33
  • 4 Jankovic J, Stone L. Dystonic tics in patients with Tourette's syndrome. Mov Disord 1991; 6 (03) 248-252
  • 5 Jankovic J. Tourette syndrome. Phenomenology and classification of tics. Neurol Clin 1997; 15 (02) 267-275
  • 6 Rizzo G, Martino D, Logroscino G. I need to freeze my gait. Mov Disord Clin Pract (Hoboken) 2015; 2 (04) 440-441
  • 7 O'Connor K. Cognitive-Behavioral Management of Tic Disorders. Wiley Online Library. 2005
  • 8 Martino D, Leckman JF. Tourette Syndrome. Oxford University Press; 2013
  • 9 Freeman RD, Zinner SH, Müller-Vahl KR. et al. Coprophenomena in Tourette syndrome. Dev Med Child Neurol 2009; 51 (03) 218-227
  • 10 Leckman JF, Riddle MA, Hardin MT. et al. The Yale Global Tic Severity Scale: initial testing of a clinician-rated scale of tic severity. J Am Acad Child Adolesc Psychiatry 1989; 28 (04) 566-573
  • 11 McGuire JF, Piacentini J, Storch EA. et al. A multicenter examination and strategic revisions of the Yale Global Tic Severity Scale. Neurology 2018; 90 (19) e1711-e1719
  • 12 Hirschtritt ME, Lee PC, Pauls DL. et al; Tourette Syndrome Association International Consortium for Genetics. Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome. JAMA Psychiatry 2015; 72 (04) 325-333
  • 13 Freeman RD, Fast DK, Burd L, Kerbeshian J, Robertson MM, Sandor P. An international perspective on Tourette syndrome: selected findings from 3,500 individuals in 22 countries. Dev Med Child Neurol 2000; 42 (07) 436-447
  • 14 Cath DC, Hedderly T, Ludolph AG. et al; ESSTS Guidelines Group. European clinical guidelines for Tourette syndrome and other tic disorders. Part I: assessment. Eur Child Adolesc Psychiatry 2011; 20 (04) 155-171
  • 15 Jankovic J. Botulinum toxin in the treatment of dystonic tics. Mov Disord 1994; 9 (03) 347-349
  • 16 Jagger J, Prusoff BA, Cohen DJ, Kidd KK, Carbonari CM, John K. The epidemiology of Tourette's syndrome: a pilot study. Schizophr Bull 1982; 8 (02) 267-278
  • 17 Kwak C, Dat Vuong K, Jankovic J. Premonitory sensory phenomenon in Tourette's syndrome. Mov Disord 2003; 18 (12) 1530-1533
  • 18 Banaschewski T, Woerner W, Rothenberger A. Premonitory sensory phenomena and suppressibility of tics in Tourette syndrome: developmental aspects in children and adolescents. Dev Med Child Neurol 2003; 45 (10) 700-703
  • 19 Leckman JF, Walker DE, Cohen DJ. Premonitory urges in Tourette's syndrome. Am J Psychiatry 1993; 150 (01) 98-102
  • 20 Hallett M. Tourette syndrome: update. Brain Dev 2015; 37 (07) 651-655
  • 21 Robertson MM, Eapen V, Singer HS. et al. Gilles de la Tourette syndrome. Nat Rev Dis Primers 2017; 3: 16097
  • 22 Szejko N, Jakubczyk A, Dunalska A, Janik P. Dystonic tics in patients with Gilles de la Tourette syndrome. Neurol Neurochir Pol 2019; 53 (05) 335-340