Secondary tics after osmotic demyelination syndrome involving both the striatum and the cerebral cortex

Although some reports have associated parkinsonism, dystonia, and chorea with the extrapontine lesions of osmotic demyelination syndrome (ODS), to our knowledge delayed-onset tic disorder has not been reported. Thus, we report a rare secondary tic associated with ODS involving both the striatum and the cerebral cortex. We can hypothesize that aberrant neuronal plasticity after the initial insult in both basal ganglia and motor cortical areas could be implicated in the pathogenesis of delayed-onset tics.