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Generating Acute and Chronic Experimental Models of Motor Tic Expression in Rats
Published on: May 27, 2021
Malignant Tourette syndrome
Min-Yuen Cynthia Cheung1, Joohi Shahed, Joseph Jankovic
1Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA.
Tourette syndrome (TS) can present with severe, life-threatening symptoms in about 5% of cases, termed malignant TS. This severe form is linked to obsessive-compulsive disorder and other behavioral issues, often resisting medical treatment.
Area of Science:
- Neurology
- Psychiatry
- Genetics
Background:
- Tourette syndrome (TS) is a neurological disorder characterized by motor and vocal tics.
- While often not disabling, TS can present with severe, life-threatening complications.
Observation:
- This study reviewed 333 patients with TS, identifying 17 (5.1%) with "malignant TS."
- Malignant TS was defined by >=2 ER visits or >=1 hospitalization for TS symptoms or comorbidities.
- Reasons for admission included tic-related injuries, self-injurious behavior (SIB), aggression, and suicidal ideation/attempts.
Findings:
- Patients with malignant TS showed higher rates of obsessive-compulsive behavior/disorder (OCB/OCD), complex tics, coprolalia, SIB, mood disorders, and suicidal ideation compared to non-malignant TS.
- OCD/OCB appeared central to malignant TS, correlating with life-threatening tics, SIB, and suicidal ideation.
- Malignant TS was associated with more severe motor symptoms and multiple behavioral comorbidities, and was more treatment-refractory.
Implications:
- Recognizing malignant TS is crucial for identifying patients at risk for severe complications.
- The strong link with OCB/OCD suggests targeted interventions for these comorbidities may be vital.
- Further research into treatment-resistant malignant TS is warranted.
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