Increased Incidence of Functional (Psychogenic) Movement Disorders in Children and Adults Amid the COVID-19 Pandemic

Hull, Mariam; Parnes, Mered; Jankovic, Joseph

doi:10.1212/cpj.0000000000001082

Cited by 76 publications

(99 citation statements)

References 37 publications

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“… 17 Interestingly, only recently, an increase in FMD during the COVID-19 pandemic has been reported from a US movement disorder centre with tremor being the most common presentation. 5 Similar to our cases, however, one teenager developed functional tics after watching another teenager on TikTok apparently presenting with ‘Tourette syndrome’.…”

Section: Justification Of the Concept Of Msmisupporting

confidence: 82%

“…clearing one’s throat) were clearly in the background or completely absent, although being the most common and typical symptoms in Tourette syndrome; (iv) movements were mainly complex and stereotyped, and predominantly located in the arms and body instead of in the eyes and face; (v) overall, the number of different movements, noises and words was ‘countless’ and far beyond the typical number of tics in Tourette syndrome; and (vi) premonitory feelings were reported with atypical location, quality and duration compared to tics in Tourette syndrome. Thus, worsening of pre-existing Tourette syndrome, for example due to the COVID-19 pandemic as suggested elsewhere, 4 , 5 can be clearly ruled out in our patients.…”

Section: Affected Teenagers Of Msmi Present With Functional Tourette-...supporting

confidence: 67%

“…Recently, in several countries including Germany, UK, 4 USA, 5 Denmark, France and Canada (personal communication), an increasing number of videos were released on social media platforms such as YouTube, TikTok and Instagram showing people who claim to be suffering from Tourette syndrome—a childhood onset chronic combined motor and vocal tic disorder—while in fact most individuals had functional symptoms only resembling Tourette syndrome. On 21 February 2019—only shortly before the first patient with MSMI presented in our clinic in May 2019—the German YouTube channel Gewitter im Kopf (English, ‘thunderstorm in the brain’) was launched by a 22-year-old man called Jan Zimmermann.…”

Section: Prerequisites Enabling Current Outbreak Of Social Media-indu...mentioning

confidence: 99%

“…Interestingly, at the same time in other countries, similar channels launched on YouTube and TikTok so these influencers may act as further ‘virtual’ index cases (personal communication). 4 , 5 …”

Section: Msmi Is Initiated By ‘Virtual’ Index Casesmentioning

confidence: 99%

See 3 more Smart Citations

Stop that! It’s not Tourette’s but a new type of mass sociogenic illness

Müller‐Vahl

Pisarenko

Jakubovski

et al. 2021

Brain

115

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We report the first outbreak of a new type of mass sociogenic illness (MSI) that in contrast to all previously reported episodes is spread solely via social media. Accordingly, we suggest the more specific term “mass social media-induced illness” (MSMI). In Germany, current outbreak of MSMI is initiated by a “virtual” index case, who is the second most successful YouTube creator in Germany and enjoys enormous popularity among young people. Affected teenagers present with similar or identical functional “Tourette-like” behaviours, which can be clearly differentiated from tics in Tourette syndrome. Functional “Tourette-like” symptoms can be regarded as the “modern” form of the well-known motor variant of MSI. Moreover, they can be viewed as the 21th century expression of a culture-bound stress reaction of our post-modern society emphasizing the uniqueness of individuals and valuing their alleged exceptionality, thus promoting attention-seeking behaviours and aggravating the permanent identity crisis of modern man. We wish to raise awareness of the current global “Tourette-like” MSMI outbreak. A large number of young people across different countries are affected, with considerable impact on health care systems and society as a whole, since spread via social media is no longer restricted to specific locations such as local communities or school environments.spread via social media is no longer restricted to specific locations such as schools or towns.

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Section: Justification Of the Concept Of Msmisupporting

confidence: 82%

Section: Affected Teenagers Of Msmi Present With Functional Tourette-...supporting

confidence: 67%

Section: Prerequisites Enabling Current Outbreak Of Social Media-indu...mentioning

confidence: 99%

Section: Msmi Is Initiated By ‘Virtual’ Index Casesmentioning

confidence: 99%

See 2 more Smart Citations

Stop that! It’s not Tourette’s but a new type of mass sociogenic illness

Müller‐Vahl

Pisarenko

Jakubovski

et al. 2021

Brain

115

View full text Add to dashboard Cite

show abstract

“…

Since the second wave of the COVID-19 pandemic, clinicians worldwide have reported an influx of young people, predominantly female teenagers, presenting with the rapid first onset of complex motor and vocal tic-like behaviours [1]. These tic-like behaviours develop and peak in severity within hours to days, cause significant functional impairment, and display phenomenological similarities to popular TikTok video content of individuals with tics or tic-like behaviours [2,3]. In January 2021, we launched our Adult Tic Disorders Clinical Registry, a prospective cohort study enrolling all adults seen in our program with tics.

…”

mentioning

confidence: 99%

Rapid onset of functional tic‐like behaviours in young adults during the COVID‐19 pandemic

Pringsheim

Martino

2021

Euro J of Neurology

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Background and purpose Clinicians have reported an increase in functional tic‐like behaviours in children and youth during the COVID‐19 pandemic. We describe adults developing rapid onset of functional tic‐like behaviours between May 2020 and June 2021. Methods Data were analysed from the Adult Tic Disorders Registry, a single‐site,12‐month prospective cohort study that began enrolment in January 2021. We compared clinical features of participants with Tourette syndrome or persistent motor/vocal tic disorder to participants with rapid onset tic‐like behaviours. Results Thirty‐three participants registered between January and June of 2021; nine had rapid onset tic‐like behaviours, and 24 had Tourette syndrome or persistent motor tic disorder. Participants with rapid onset tic‐like behaviours were younger (19.9 vs. 38.6 years, p = 0.003), had older age at onset (15.3 vs. 10.1, p = 0.0009), and were more likely female (p < 0.0001). They had higher motor and vocal tic severity and impairment scores (all p < 0.01) and were more likely to have complex arm/hand motor tics (p < 0.0001), complex vocal tics (p < 0.0001), and coprolalia (p = 0.004). They had significantly higher scores on all mental health symptom self‐report measures (all p < 0.05) and were significantly more likely to be diagnosed with depression (p = 0.03). Conclusions The clinical features that help differentiate rapid onset tic‐like behaviours from Tourette syndrome or persistent motor tic disorder include their phenomenology, onset age, and clinical course. Rapid onset tic‐like behaviours are a distinct subtype of functional neurological disorder that has emerged during the COVID‐19 pandemic in young people and appears to be strongly socially influenced.

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Prognosis of rapid onset functional tic‐like behaviors: Prospective follow‐up over 6 months

2022

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Background and Purpose The prognosis of rapid onset functional tic‐like behaviors (FTLBs) is unknown. This prospective cohort study describes the course and treatment of rapid onset FTLBs in adolescents (n = 20) and adults (n = 9) previously reported in two case series. Methods Yale Global Tic Severity Scale (YGTSS) scores were compared between first clinical presentation and 6‐month follow‐up assessment. All treatments used for FTLBs and any psychiatric comorbidities were recorded. Results In adolescents with FTLBs, motor tics, vocal tics, total tics, impairment, and global scores on the YGTSS significantly improved at 6 months, with a mean decrease in the YGTSS global score of 31.9 points, 95% confidence interval (CI) 15.4, 48.4, p = .0005. In adults with FTLBs, only impairment and global scores significantly improved, with a mean decrease in the YGTSS global score of 19.6 points, 95% CI −3.2, 42.3, p = .04. Selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT) for anxiety and depression were the most used treatment in both age groups. Conclusions This prospective study suggests that adolescents have a better prognosis than adults with FTLBs. Management of comorbidities with SSRIs and CBT seems effective.

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Increased Incidence of Functional (Psychogenic) Movement Disorders in Children and Adults Amid the COVID-19 Pandemic

Cited by 76 publications

References 37 publications

Stop that! It’s not Tourette’s but a new type of mass sociogenic illness

Stop that! It’s not Tourette’s but a new type of mass sociogenic illness

Rapid onset of functional tic‐like behaviours in young adults during the COVID‐19 pandemic

Prognosis of rapid onset functional tic‐like behaviors: Prospective follow‐up over 6 months

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