Myelopathy caused by tics in an adolescent, associated with T2 signal intensity changes of the spinal cord

Muroi, Ai; Matsumura, Akira; Asakawa, Hiroyuki; Enomoto, Takao; Iwasaki, Naoko; Nose, Tadao

doi:10.1007/s00381-002-0563-6

Cited by 14 publications

(12 citation statements)

References 10 publications

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“…These results probably indicate that segment stabilization is not enough to make myelopathy disappear and that treatment is necessary to control the tics. If involuntary movements persist after surgery, the risk recurrence increases; thus, pharmacologic treatment is as important as neurosurgical intervention 8 .…”

Section: Discussionmentioning

confidence: 99%

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Motor tic disorder and traumatic cervical myelopathy: a case report

Sfreddo

Cecchini²,

Raupp

et al. 2011

Coluna/Columna

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The association between motor tics and cervical myelopathy is rare and not well understood. Only a few papers in the literature reported this disorder until the present date. This is a case report of a cervical myelopathy case secondary to a motor tic disorder. A 23-year-old male with a 10-year history of motor tic disorder, involving sudden forced extension of the head and cervical spine. Disturbed tactile sensation and kinetic posturing that progressed to the Lhermitte sign every time he made the movement were detected over the last six months. Magnetic resonance imaging (MRI) showed hyperintense intramedullary lesion at C2-C3, degeneration at C3-C4, and no signs of spinal cord compression. On sagittal view, functional MRI with head extension showed anterior compression with protrusion of the intervertebral disc and posterior compression of the yellow ligaments causing spinal cord stenosis. Anterior discectomy and fixation of C3-C4 were performed. There were no complications. The patient showed improvement and the motor tics were controlled by haloperidol. The patient remains symptom-free after 2 years of follow-up. Uncontrolled motor tics can compromise spinal cord function. Functional MRI can reproduce the abnormal movements and clarify the physiopathology.

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Section: Discussionmentioning

confidence: 99%

“…Their prevalence ranges between 5 to 100 cases per 10,000 2 . Only a few papers reporting the association between motor tics and cervical myelopathy have been found in the literature 1,[3][4][5][6][7][8][9][10] . We report a case of a cervical motor tic that caused a traumatic cervical myelopathy.…”

Section: Introductionmentioning

confidence: 99%

Motor tic disorder and traumatic cervical myelopathy: a case report

Sfreddo

Cecchini²,

Raupp

et al. 2011

Coluna/Columna

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“…There have been a few case reports of cervical myelopathy complicating cervical tics in patients with severe Tourette's syndrome . However, there is very little in the literature concerning how best to treat such patients.…”

Section: Case Reportmentioning

confidence: 99%

“…There have been a few case reports of cervical myelopathy complicating cervical tics in patients with severe Tourette's syndrome. [1][2][3][4][5] However, there is very little in the literature concerning how best to treat such patients. We present a case of a patient with Tourette's syndrome complicated by cervical myelopathy whom we treated successfully with urgent bilateral anteromedial globus pallidus deep brain stimulation (DBS).…”

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confidence: 99%

Cervical myelopathy secondary to Tourette's syndrome managed by urgent deep brain stimulation

et al. 2014

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“…reported the case of a patient in whom the fusion was broken after surgery [6], Krauss and Jankovic reported a patient with late neurological deterioration that occurred several years after surgery [2] and Dobbs and Berger reported the case of a patient whose symptoms worsened just 10 weeks after surgery [5]. The other four cases were not followed-up over the long term [3,4,9]. …”

Section: Introductionmentioning

confidence: 99%

Multiple neck operations in a patient with severe motor tics because of Tourette’s syndrome: a case report

et al. 2012

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IntroductionIn patients with Tourette’s syndrome who have severe motor tics, involuntary neck movements can enhance degenerative changes in the cervical spine, occasionally causing myelopathy. There have been a limited number of reports on surgical treatment for cervical myelopathy caused by Tourette’s syndrome, and a consensus for surgical treatment has not been fully established. To the best of our knowledge, this is the first report that describes a case of cervical myelopathy in a patient with Tourette’s syndrome with severe motor tics who has undergone multiple surgeries of the cervical spine.Case presentationA 44-year-old Asian man with severe motor tics due to Tourette’s syndrome presented with cervical myelopathy. Previously, he had undergone an anterior discectomy and spinal fusion with ceramics at the C3-C4 and C5-C6 levels, but required further surgery because of displacement of the ceramics. After the second operation, he developed compression myelopathy at the sandwiched (C4-C5) disc level, and had to undergo a C4-C5 anterior discectomy and spinal fusion, which was unsuccessful.As a salvage operation, we performed a C3-C7 decompression and spinal fusion from both the anterior and posterior approaches. By thorough postoperative external immobilization of his neck, our patient’s spinal fusion was successful and his neurological improvements were maintained for more than 10 years.ConclusionsPatients with Tourette’s syndrome with cervical myelopathy are at risk of having multiple neck operations to correct their symptoms. Postoperative immobilization and the correct selection of surgical procedure are quite important for successful spinal fusion and for avoiding complications at adjacent levels in these patients.

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Myelopathy caused by tics in an adolescent, associated with T2 signal intensity changes of the spinal cord

Cited by 14 publications

References 10 publications

Motor tic disorder and traumatic cervical myelopathy: a case report

Motor tic disorder and traumatic cervical myelopathy: a case report

Cervical myelopathy secondary to Tourette's syndrome managed by urgent deep brain stimulation

Multiple neck operations in a patient with severe motor tics because of Tourette’s syndrome: a case report

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