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Coexistence of tics and parkinsonism: evidence for non-dopaminergic mechanisms in tic pathogenesis
1Morton and Gloria Shulman Movement Disorders Centre, Department of Medicine, University of Toronto, Ontario, Canada.
Neurology
|December 31, 1997
Abstract:
We report four patients with tics since childhood who presented with typical Parkinson's disease (PD). No alteration in tics occurred before or during the development of symptoms. L-Dopa/carbidopa therapy in three patients improved parkinsonism without worsening tics over 3 months to 11 years of follow-up. Our experience fails to support hypotheses exclusively emphasizing overactivity of dopaminergic function underlying tics that would predict that PD would reduce and L-dopa exacerbate tics. This emphasizes the role of other neurotransmitter systems in the pathophysiology of tics.