Objective: To determine the interference of tics in Tourette’s syndrome on driving.

Background: Driving ability may be impaired in patients with various movement disorders, but it has not been studied in patients with Tourette syndrome (TS). There have been many reports of the impact of various, mostly parkinsonian, movement disorders on driving performance, but hyperkinetic disorders have not been well addressed in studies of driving and movement disorders. Specifically, the phenomenological effects of TS tics on driving have not been well studied and has been only addressed in one case report (1) and a study attributing driving impairment in Tourette’s to comorbid ADHD (2).  In the current case series, we aim to characterize driving impairment in patients with TS related to their tics.

Method: We included patients with TS ages 16 to 65 followed at our Movement Disorders Clinic in whom severe tics have had interfered with their driving abilities. We analyzed the clinical phenomenology of the patients and its impact on driving.

Results: We found 6 patients that fulfilled the criteria in our case series and included them in the study. Patients were videotaped and 1 patient described her driving impairment in video after a standard informed consent was signed. The motor tics involved facial muscles and caused visual impairment because of frequent blinking and blepharospasm, but limb and truncal tics also seriously impacted their driving.

Conclusion: Motor tics may adversely affect driving ability of patients with TS potentially causing danger to themselves and others.  Screening for such impairments should be considered in patients with TS, particularly in teenagers who are being evaluated for driver’s licensing.

References: 1. Brunnauer A, Segmiller FM, Volkamer T, Laux G, Müller N, Dehning S. Cannabinoids improve driving ability in a Tourette’s patient. Psychiatry Res [Internet]. 2011;190(2–3):382. Available from: http://dx.doi.org/10.1016/j.psychres.2011.05.033 2. Mataix-Cols D, Brander G, Chang Z, Larsson H, D’Onofrio BM, Lichtenstein P, et al. Serious Transport Accidents in Tourette Syndrome or Chronic Tic Disorder. Mov Disord. 2020;2:1–9.

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