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Tourettism and dystonia after subcortical stroke
Author(s) -
Kwak Carolyn H.,
Jankovic Joseph
Publication year - 2002
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.10207
Subject(s) - tics , stroke (engine) , dystonia , tourette syndrome , psychology , neurological disorder , tic disorder , pediatrics , blepharospasm , central nervous system disease , movement disorders , age of onset , medicine , physical medicine and rehabilitation , psychiatry , neuroscience , disease , mechanical engineering , engineering
The term “tourettism” has been used to describe Tourette syndrome (TS)‐like symptoms secondary to some specific cause. Tics associated with attention deficit hyperactivity disorder (ADHD), obsessive–compulsive disorder (OCD), or both, are commonly present in TS, but this constellation of symptoms has been rarely attributed to stroke. We describe two boys who suffered a subcortical stroke and subsequently developed hemidystonia, tics, and behavioral comorbidities. Both had right hemispheric stroke involving the basal ganglia at 8 years of age, and in both the latency from the stroke to the onset of left hemidystonia was 2 weeks. In addition to ADHD and OCD, both exhibited cranial‐cervical motor tics but no phonic tics. The temporal relationship between the stroke and subsequent TS‐like symptoms, as well as the absence of phonic tics and family history of TS symptoms in our patients, argues in favor of a cause and effect relationship, and the observed association provides evidence for an anatomic substrate for TS and related symptoms. © 2002 Movement Disorder Society