Journal
EUROPEAN JOURNAL OF NEUROLOGY
Volume 22, Issue 3, Pages 527-U52Publisher
WILEY
DOI: 10.1111/ene.12609
Keywords
functional; psychogenic; tics
Categories
Funding
- EFNS
- Deutsche Forschungsgemeinschaft [GA2031/1-1]
- Movement Disorders Society
- Actelion
- Ipsen
- GlaxoSmithKline
- Orion Corporation
- Merz Pharmaceuticals LLC
- Halley Stewart Trust through Dystonia Society UK
- Wellcome Trust MRC strategic neurodegenerative disease initiative [WT089698]
- Dystonia Coalition
- Parkinson's UK [G-10]
- National Institute for Health Research
- Parkinson's UK
- UK Dystonia Society
- Bachmann Strauss Foundation
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Background and purposeFunctional tics, also called psychogenic tics or pseudo-tics, are difficult to diagnose because of the lack of diagnostic criteria and their clinical similarities to organic tics. The aim of the present study was to report a case series of patients with documented functional tics and to describe their clinical characteristics, risk factors and psychiatric comorbidity. Also clinical tips are suggested which might help the differential diagnosis in clinical practice. Methods and resultsEleven patients (mean age at onset 37.2, SD 13.5; three females) were included with a documented or clinically established diagnosis of functional tics, according to consultant neurologists who have specific expertise in functional movement disorders or in tic disorders. Adult onset, absent family history of tics, inability to suppress the movements, lack of premonitory sensations, absence of pali-, echo- and copro-phenomena, presence of blocking tics, the lack of the typical rostrocaudal tic distribution and the coexistence of other functional movement disorders were common in our patients. ConclusionsOur data suggest that functional tics can be differentiated from organic tics on clinical grounds, although it is also accepted that this distinction can be difficult in certain cases. Clinical clues from history and examination described here might help to identify patients with functional tics.
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