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The clinical syndrome of primary tic disorder associated with dystonia: A large clinical series and a review of the literature.
MedLine Citation:
PMID:  21506147     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: The co-occurrence of tics and dystonia as an idiopathic condition has only rarely been reported. We report a series of patients with tics and persistent dystonia, with the aim of determining the prevalence and clinical characteristics of this syndrome.
METHODS: Analysis of clinical database of patients with tic disorders.
RESULTS: From our database of 224 patients with tics, 20 had co-occurrence of tics and dystonia as a primary disorder. Six patients had Tourette's syndrome, and 2 had idiopathic chronic motor/phonic tics. Twelve of the 20 had adult onset of tics (9 with motor/phonic tics and 3 with motor tics). Dystonia was focal in 12 patients (cervical most common) and segmental in 8. A sensory geste was present in 8. Mean age of tic onset and dystonia was 28.3 ± 19.7 and 40.5 ± 15.3 years, respectively. Tics preceded dystonia in 12, dystonia preceded tics in 4, and 1 patient had simultaneous onset of tics and dystonia. In 3 patients, symptoms' sequence could not be determined. Only 8 patients required treatment for their tics. Botulinum toxin was the mainstay of dystonia treatment (16 patients), whereas 6 received trihexyphenidyl. Six patients each had depression and obsessive compulsive symptoms, and 5 had attention-deficit and hyperactivity disorder.
DISCUSSION: We have further characterized the syndrome of a primary condition of tics associated with persistent focal/segmental dystonia. Apart from the presence of dystonia, our data suggest that these patients are differentiated from pure tic disorders by a later age of onset, lesser severity of tics, and lower frequency of associated features. © 2011 Movement Disorder Society.
Authors:
Joana Damásio; Mark J Edwards; Araceli Alonso-Canovas; Petra Schwingenschuh; Georg Kägi; Kailash P Bhatia
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Publication Detail:
Type:  Journal Article     Date:  2011-01-12
Journal Detail:
Title:  Movement disorders : official journal of the Movement Disorder Society     Volume:  26     ISSN:  1531-8257     ISO Abbreviation:  Mov. Disord.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-04-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610688     Medline TA:  Mov Disord     Country:  United States    
Other Details:
Languages:  eng     Pagination:  679-84     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Movement Disorder Society.
Affiliation:
Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom; Neurology Department, Hospital de Santo Antonio, Centro Hospitalar do Porto, Porto, Portugal.
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