Tourettism Explained

Tourettism refers to the presence of Tourette-like symptoms in the absence of Tourette syndrome, as the result of other diseases or conditions, known as "secondary causes".

Tourette syndrome (TS) is an inherited neurological condition of multiple motor and at least one vocal tic. Although Tourette syndrome is the most common cause of tic disorders,^[1] other sporadic, genetic, and neurodegenerative disorders may also exhibit tics.^{[2] [3]}

Conditions that may manifest tics or stereotyped movements include developmental disorders; autism spectrum disorders^[4] and stereotypic movement disorder;^{[1] [5]} Sydenham's chorea; idiopathic dystonia; and genetic conditions such as Huntington's disease, neuroacanthocytosis, pantothenate kinase-associated neurodegeneration, Duchenne muscular dystrophy, Wilson's disease, and tuberous sclerosis. Other possibilities include chromosomal disorders such as Down syndrome, Klinefelter syndrome, XYY syndrome and fragile X syndrome. Acquired causes of tics include drug-induced tics, head trauma, encephalitis, stroke, and carbon monoxide poisoning. The symptoms of Lesch–Nyhan syndrome may also be confused with Tourette syndrome.^[6]

Tic mimickers

• Chorea (disease)^[2]
• Myoclonus^[2]
• Dystonia^[2]
  • Torsion dystonia^[2]
  • Idiopathic dystonia

Genetic/chromosomal

• Chromosomal abnormalities
• Citrullinemia^[1]
• Down syndrome
• Duchenne muscular dystrophy
• Fragile X syndrome
• Pantothenate kinase-associated neurodegeneration
• Huntington's disease^[7]
• Klinefelter syndrome^[7]
• Lesch–Nyhan syndrome^[2]
• Neuroacanthocytosis^[7]
• Neurodegeneration^[1]
• Phenylketonuria^[1]
• Schizophrenia^[7]
• Tuberous sclerosis^[7]
• Wilson's disease^[7]
• XYY syndrome^[7]

Infectious or post-infectious

• Encephalitis^[7]
• Mycoplasma pneumoniae^[2]
• Sydenham's chorea^[7]

Developmental

• Pervasive developmental disorders
  • Asperger syndrome^[7]
  • Autism spectrum^[7]
  • Rett syndrome^[2]
• Intellectual disability^[7]
• Static encephalopathy^[2]
• Stereotypic movement disorder^{[2] [8]}

Toxins/insults/acquired

• Carbon monoxide poisoning^[7]
• Cerebral palsy^[9]
• Creutzfeldt–Jakob disease^[7]
• Fetal alcohol syndrome^[1]
• Head trauma^[7]
• Hypoglycemia^[7]
• Intrauterine exposure to illicit drugs
• Intrauterine infections
• Mercury^[2]
• Neurocutaneous syndromes^[10]
• Neurosyphilis^[7]
• Perinatal asphyxia
• Psychogenic disease^{[1] [2]}
• Stroke^[7]
• Wasp venom^[2]

Drugs

• Cocaine^[7]
• Levodopa (Dopar, Larodopa)^[7]
• Antiepileptics^[7] Carbamazepine (Atretol, Epitol, Tegretol)^[3]
• Lamotrigine (Lamictal)^[3]
• Amphetamines^[7]
• Pemoline^[7]
• Phenytoin (Dilantin)^[2]
• Phenobarbital^[2]
• Antipsychotics (e.g.; haloperidol)^{[7] [11] [12]}

References

• Black, Kevin J. Tourette Syndrome and Other Tic Disorders. eMedicine.com March 22, 2006.

Further reading

• Erer S, Jankovic J . Feb 2007 . Adult onset tics after peripheral injury . Parkinsonism Relat Disord . 14. 1. 75–6. 17292653 . 10.1016/j.parkreldis.2006.12.009.

Notes and References

1. Jankovic J, Mejia NI . 2006 . Tics associated with other disorders . Adv Neurol . 99 . 61–8 . 16536352 .
2. Secondary tics and tourettism . 15867978 . 27 . 1 . March 2005 . Mejia NI, Jankovic J . Rev Bras Psiquiatr . 11–7 . 10.1590/s1516-44462005000100006 . bot: unknown . https://web.archive.org/web/20070628191850/http://www.scielo.br/pdf/rbp/v27n1/23707.pdf . 2007-06-28 . free .
3. Evidente, GH. "Is it a tic or Tourette's? Clues for differentiating simple from more complex tic disorders." PostGraduate Medicine Online. October 2000 108:5. Available at archive.org
4. Ringman JM, Jankovic J . Occurrence of tics in Asperger's syndrome and autistic disorder . J. Child Neurol. . 15 . 6 . 394–400 . June 2000 . 10868783 . 10.1177/088307380001500608 . Case report.
5. Web site: Freeman RD . Tourette's syndrome: minimizing confusion . https://web.archive.org/web/20060411182519/http://www.tourette-confusion.blogspot.com/ . April 11, 2006 . Roger Freeman, MD, blog . February 8, 2006.
6. Rapin I . Autism spectrum disorders: relevance to Tourette syndrome . Adv Neurol . 85 . 89–101 . 2001 . 11530449 . Review.
7. Bagheri M, Kerbeshian J, Burd L . Recognition and management of Tourette's syndrome and tic disorders . Am Fam Physician . 59 . 8 . 2263–72, 2274 . 1999 . 10221310. Full text
8. Web site: Freeman RD . Tourette's syndrome: minimizing confusion . https://web.archive.org/web/20060411182519/http://www.tourette-confusion.blogspot.com/ . April 11, 2006 . Roger Freeman, MD, blog . February 8, 2006.
9. Evidente, GH. "Is it a tic or Tourette's? Clues for differentiating simple from more complex tic disorders." PostGraduate Medicine Online. October 2000 108:5. Available at archive.org
10. Evidente, GH. "Is it a tic or Tourette's? Clues for differentiating simple from more complex tic disorders." PostGraduate Medicine Online. October 2000 108:5. Available at archive.org
11. Bharucha KJ, Sethi KD . Nov 1995 . Tardive tourettism after exposure to neuroleptic therapy . Mov Disord . 10 . 6. 791–3 . 8749999 . 10.1002/mds.870100613.
12. eMedicine article on Tardive dyskinesia Full article