Objective: The aim of our study was to investigate lifetime prevalence and clinical correlates of dystonic tics in Polish cohort of Gilles de la Tourette patients.

Background: Gilles de la Tourette syndrome (GTS) is a childhood onset disorder characterized by motor and vocal tics. Different types of motor tics may occur in GTS, among other, dystonic tics (DTs). DTs last longer than clonic tics, are characterized by abnormal dystonia-like movements that lead to transient, not fixed posture. Although DTs have been recognized as part of GTS symptomatology, little is known about their risk factors and how often and at which age they appear in affected individuals.

Method: We performed a prospective, one-registration study in a cohort of 207 consecutive ambulatory patients (76 adults and 131 children) with GTS. Duration of GTS was 9.0±8.0 years (range: 1-39 years). DTs were diagnosed during the interview.

Results: DTs occurred at some point in the lifetime of 73.9% (n=153) patients. In 41.2% of patients (n=63) DTs was only present in the past, but not at the time of evaluation. The prevalence of DTs in adults and children was almost the same (75%, n=57 vs 73.2%, n=96, respectively). Age at onset of DTs was known only in 57% (n=86) of patients with the most frequent onset in children (7-11 years, 74.4%, n=64), followed by adolescence (12-18 years; 17.4%, n=15) and adulthood (≥18 years, 8.1%, n=7). DTs occurred 3.7±4.2 years after the tic onset and mean age of DTs onset was 9.9±5.2 years. On average patients suffered from 1.8±1.7 types of DTs. The most frequent manifestations of DTs were: eyes (tightening resembling blepharospasm 84.3%, n=129and oculogyric crisis 45.8%, n=70), trunk (dystonic postures 59.5%, n=91), jaw ( bruxism 34.6%, n=53), neck (30.7%, n=47), upper limb (26.1%, n=40) and foot (20.9%, n=32). Multivariate logistic regression analysis showed significant associations of DTs with total number of simple and total number of complex tics.

Conclusion: DTs are early and frequent symptoms of GTS. They tend to localize in the face area. DTs occur more frequently in individuals with the higher number of tics and probably add to global impairment caused by tics.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/dystonic-tics-in-patients-with-gilles-de-la-tourette-syndrome/