Progressive Cervical Spondylotic Myelopathy Caused by Tic Disorders in a Young Adult with Tourette Syndrome
10.13004/kjnt.2019.15.e24
- Author:
Jonggil KIM
1
;
Ji Yoon KIM
;
Ja Myoung LEE
;
Dong Ho KANG
;
Chul Hee LEE
;
In Sung PARK
;
Young Seok LEE
Author Information
1. Department of Neurosurgery, Gyeongsang National University School of Medicine, Jinju, Korea. leeys1026@hanmail.net
- Publication Type:Case Report
- Keywords:
Tic disorders;
Spinal cord disease;
Spondylosis;
Tourette syndrome
- MeSH:
Botulinum Toxins;
Cervical Cord;
Dyskinesias;
Humans;
Laminoplasty;
Magnetic Resonance Imaging;
Neck;
Quadriplegia;
Spinal Cord Diseases;
Spine;
Spondylosis;
Tic Disorders;
Tics;
Tourette Syndrome;
Upper Extremity;
Young Adult
- From:Korean Journal of Neurotrauma
2019;15(2):199-203
- CountryRepublic of Korea
- Language:English
-
Abstract:
Involuntary movement of the cervical spine can cause damage to the cervical spinal cord. Cervical myelopathy may occur at an early age in involuntary movement disorders, such as tics. We report the case of a 21-year-old man with Tourette syndrome, who developed progressive quadriparesis, which was more severe in the upper extremities. The patient had abnormal motor tics with hyperflexion and hyperextension of the cervical spine for more than 10 years. High-signal intensity intramedullary lesions were observed at C3-4-5-6 level on T2 weighted magnetic resonance imaging. Examinations were performed for high-signal intensity intramedullary lesions that may occur at a young age, but no other diseases were detected. Botulinum toxin injection to the neck musculature and medication for tic disorders were administered. However, the myelopathy was further aggravated, as the involuntary cervical movement still remained. Therefore, laminoplasty was performed at C3-4-5-6, with posterior fixation at C2-3-4-5-6-7 to alleviate the symptoms. The neurological signs and symptoms improved dramatically. The management of tic disorders should be the first priority during treatment. However, surgical treatment may be necessary, if symptoms worsen after appropriate treatment.
