A Tic-ing Time Bomb: Case Report of a Unique Presentation of Sudden-onset Tics

Tics in children are commonly diagnosed and not usually a cause for concern. Rarely, they may present as a symptom of underlying intracranial pathology.

We describe an adolescent with sudden-onset tics following a fall who presented to the emergency department and was diagnosed with an arteriovenous malformation with parenchymal hemorrhage. He underwent a successful embolization, after which his tics resolved.

When evaluating a patient with tics, an atypical history or abnormal physical exam findings should raise suspicion for possible secondary etiologies, including arteriovenous malformation and stroke.