Tourette Syndrome and Driving

Abstract

BackgroundBackground: Driving ability may be impaired in patients with various movement disorders, but it has not been studied in patients with Tourette syndrome (TS). Cases Cases: We describe a series of 6 patients from our large cohort of TS patients followed in our movement disorders clinic in whom severe tics have had interfered with their driving abilities. The motor tics involved facial muscles and caused visual impairment because of frequent blinking and transient blepharospasm (dystonic tic), but complex limb and truncal tics also seriously impacted their driving. Conclusions Conclusions: Although majority of patients with TS have no functional impairment, severe motor tics in some patients may adversely affect their driving ability, potentially causing danger to themselves and others. Screening for such troublesome tics should be considered in patients with TS, particularly in teenagers who are being evaluated for driver's licensing. Illustrative Cases Case 1The first case is a 17-year-old right-handed student who initially experienced involuntary movements as a toddler manifested by shrugging her shoulders or patting her stomach with her hands.

Driving Impairment in Movement Disorders

“…It is not clear whether patients with cervical dystonia had any limitation of the range of neck movement. From our experience, self‐reported driving impairment in patients with movement disorders may not adequately reflect actual impairment when assessed using objective measures 64 …”

“…In contrast to the first study, 37.5% of the patients attributed their driving difficulties to ADHD, while 24.5% of this cohort identified tics, mainly facial and eye tics, as the main culprit in potentially impaired driving. In our cohort of six patients with TS focusing on the phenomenology of tics (supplemented by videos) that interfered with driving, some patients experienced arm tics resulting in sudden car rotations and abrupt directional change, feet tics interfering with pedal maneuvering, along with blepharospastic, facial and head tics 64 . ADHD and impulsive behavior also contributed to impaired driving in this population of TS patients.…”

“…In our cohort of six patients with TS focusing on the phenomenology of tics (supplemented by videos) that interfered with driving, some patients experienced arm tics resulting in sudden car rotations and abrupt directional change, feet tics interfering with pedal maneuvering, along with blepharospastic, facial and head tics. 64 ADHD and impulsive behavior also contributed to impaired driving in this population of TS patients. One of our patients described the compulsion to look behind the side and rear mirror while driving.…”

“…From our experience, selfreported driving impairment in patients with movement disorders may not adequately reflect actual impairment when assessed using objective measures. 64…”