Myelopathy caused by tics in an adolescent, associated with T2 signal intensity changes of the spinal cord

A 15-year-old boy who had suffered motor tics since age 9 developed progressive cervical myelopathy involving both his hands and his lower extremities. T2-weighted MRI revealed mild canal stenosis and increased signal intensity in the cervical spinal cord beginning at the C-4 level and continuing upward to the medulla oblongata.

After C-3 to C-7 laminoplasty, the patient's clinical symptoms improved.

It is possible that movement disorders such as tics may contribute to the development of cervical myelopathy owing to the effects of involuntary movements on the neck. Such an intensity change on a T2-weighted image has never been reported in an adolescent tic disorder. Despite such changes, surgical treatment may bring about clinical improvement.