Rapid Onset Functional Tic‐Like Behaviors in Young Females During the <scp>COVID</scp>‐19 Pandemic

Pringsheim, Tamara; Ganos, Christos; McGuire, Joseph F.; Hedderly, Tammy; Woods, Douglas W.; Gilbert, Donald L.; Piacentini, John; Dale, Russell C.; Martino, Davide

doi:10.1002/mds.28778

Cited by 103 publications

(221 citation statements)

References 28 publications

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“…Demographic and clinical features were similar to the Pringsheim et al 6 cohort with respect to age at onset, severity of symptoms, and predominance of complex motor and vocal phenomena predominantly involving the trunk and arms and lack of waxing and waning. Different from Pringsheim et al's study, 6 the group comprised more males than females, although the ratio was smaller than seen in Tourette samples. In this -------------------------------------------------------- small group of patients, several clinical features were not different between this sample and those with Tourette syndrome, including premonitory sensations, ability to suppress movements and vocalizations, as well as history (self-reported) of autistic spectrum disorder, attention deficit/hyperactivity disorder, and obsessive-compulsive disorder.…”

supporting

confidence: 63%

Mind the Difference Between Primary Tics and Functional Tic‐like Behaviors

Müller-Vahl

Edwards

2021

Movement Disorders

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supporting

confidence: 63%

Mind the Difference Between Primary Tics and Functional Tic‐like Behaviors

Müller-Vahl

Edwards

2021

Movement Disorders

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“…Following declines in weekly visits associated with MHCs among children and adolescents aged 0-17 years, during 2020 compared with 2019, weekly ED visits for MHCs overall and for specific MHCs varied by age and sex during 2021 and in January 2022. The current trends in the number and proportion of MHC-related ED visits, along with previous research (1,2,(4)(5)(6)(7)(8), indicate that the mental health effects of the pandemic might be particularly high among adolescent girls.…”

Section: Discussionmentioning

confidence: 80%

Pediatric Emergency Department Visits Associated with Mental Health Conditions Before and During the COVID-19 Pandemic — United States, January 2019–January 2022

Radhakrishnan¹,

Leeb²,

Bitsko³

et al. 2022

MMWR Morb. Mortal. Wkly. Rep.

122

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On February 18, 2022, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr).In 2021, a national emergency* for children's mental health was declared by several pediatric health organizations, and the U.S. Surgeon General released an advisory † on mental health among youths. These actions resulted from ongoing concerns about children's mental health in the United States, which was exacerbated by the COVID-19 pandemic (1,2). During March-October 2020, among all emergency department (ED) visits, the proportion of mental health-related visits increased by 24% among U.S. children aged 5-11 years and 31% among adolescents aged 12-17 years, compared with 2019 (2). CDC examined changes in U.S. pediatric ED visits for overall mental health conditions (MHCs) and ED visits associated with specific MHCs (depression; anxiety; disruptive behavioral and impulse-control disorders; attention-deficit/hyperactivity disorder; trauma and stressor-related disorders; bipolar disorders; eating disorders; tic disorders; and obsessive-compulsive disorders [OCD]) during 2019 through January 2022 among children and adolescents aged 0-17 years, overall and by sex and age. After declines in weekly visits associated with MHCs among those aged 0-17 years during 2020, weekly numbers of ED visits for MHCs overall and for specific MHCs varied by age and sex during 2021 and January 2022, when compared with corresponding weeks in 2019. Among adolescent females aged 12-17 years, weekly visits increased for two of nine MHCs during 2020 (eating disorders and tic disorders), for four of nine MHCs during 2021 (depression, eating disorders, tic disorders, and OCD), and for five of nine MHCs during January 2022 (anxiety, trauma and stressor-related disorders, eating disorders, tic disorders, and OCD), and overall MHC visits during January 2022, compared with 2019. Early identification and expanded evidence-based prevention and intervention strategies are critical to improving children's and adolescents' * https://www.aap.org/en/advocacy/child-and-adolescent-healthy-mentaldevelopment/aap-aacap-cha-declaration-of-a-national-emergency-inchild-and-adolescent-mental-health/ † https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-healthadvisory.pdf

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“…As expected, the emergence of functional neurological symptoms, such as tremor and tic-like behaviors were evident, after COVID-19 has been described (11,12). Similarly, in patients with psychogenic non-epileptic seizures (PNESs), COVID-19 pandemic influenced the characteristics of functional seizures (13).…”

Section: Discussionmentioning

confidence: 57%

“…Similarly, in patients with psychogenic non-epileptic seizures (PNESs), COVID-19 pandemic influenced the characteristics of functional seizures (13). In these patients, often affected by mild symptoms in the acute phase, distinctive clinical features (i.e., positive clinical signs), along with an association with mood disorders and psychosocial stressors, have been reported (12,13). These findings suggest that COVID-19 pandemic may favor the emergence of FNDs, in line with the hypothesis that stress represents a crucial precipitating factor.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Overlap Between Long COVID and Functional Neurological Disorders

et al. 2022

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Long lasting symptoms have been reported in a considerable proportion of patients after a severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection. This condition, defined as either “post-acute coronavirus disease (COVID),” “long COVID,” or “long-haul COVID,” has also been described in outpatients and in individuals who are asymptomatic during the acute infection. A possible overlap exists between this condition and the functional neurological disorders (FNDs). We report a 23-year-old man who developed, after asymptomatic COVID-19, a complex symptomatology characterized by fatigue, episodic shortness of breath, nocturnal tachycardia, and chest pain. He also complained of attention and memory difficulties, fluctuating limb dysesthesia, and weakness of his left arm. After neurological examination, a diagnosis of FND was made. Notably, the patient was also evaluated at a post-COVID center and received a diagnosis of long COVID-19 syndrome. After 4 months of psychoanalytic psychotherapy and targeted physical therapy in our center for FNDs, dysesthesia and motor symptoms had resolved, and the subjective cognitive complaints had improved significantly. However, the patient had not fully recovered as mild symptoms persisted limiting physical activities. Long-term post COVID symptoms and FNDs may share underlying biological mechanisms, such as stress and inflammation. Our case suggests that functional symptoms may coexist with the long COVID symptoms and may improve with targeted interventions. In patients presenting with new fluctuating symptoms after SARS-CoV-2 infection, the diagnosis of FNDs should be considered, and the positive clinical signs should be carefully investigated.

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Rapid Onset Functional Tic‐Like Behaviors in Young Females During the COVID‐19 Pandemic

Abstract: This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Please cite this article as

Cited by 103 publications

References 28 publications

Mind the Difference Between Primary Tics and Functional Tic‐like Behaviors

Mind the Difference Between Primary Tics and Functional Tic‐like Behaviors

Pediatric Emergency Department Visits Associated with Mental Health Conditions Before and During the COVID-19 Pandemic — United States, January 2019–January 2022

Case Report: Overlap Between Long COVID and Functional Neurological Disorders

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