INTRODUCTION: We report a case of a 9-year-old boy with Tourette syndrome (TS) who developed progressive quadriparesis that was more severe in the upper extremities. CASE REPORT: He had experienced frequent and violent motor tics consisting of hyperflexion and hyperextension for years. Magnetic resonance imaging (MRI) revealed a focal high-signal intensity cord lesion and adjacent cervical spondylotic changes. Initially, the patient was observed for several months because of diagnostic uncertainty; his neurological status had improved and later worsened again. Anterior cervical discectomy of C3-4 and fusion immediately followed by posterior fixation were performed. After surgery, the neck collar was applied for 6 months. His neurological signs and symptoms improved dramatically. TS with violent neck motion may cause cervical spondylotic myelopathy at an early age. CONCLUSIONS: The optimal management is still unclear and attempts to control tics should be paramount. Circumferential fusion with neck bracing represents a viable treatment option.
INTRODUCTION: We report a case of a 9-year-old boy with Tourette syndrome (TS) who developed progressive quadriparesis that was more severe in the upper extremities. CASE REPORT: He had experienced frequent and violent motor tics consisting of hyperflexion and hyperextension for years. Magnetic resonance imaging (MRI) revealed a focal high-signal intensity cord lesion and adjacent cervical spondylotic changes. Initially, the patient was observed for several months because of diagnostic uncertainty; his neurological status had improved and later worsened again. Anterior cervical discectomy of C3-4 and fusion immediately followed by posterior fixation were performed. After surgery, the neck collar was applied for 6 months. His neurological signs and symptoms improved dramatically. TS with violent neck motion may cause cervical spondylotic myelopathy at an early age. CONCLUSIONS: The optimal management is still unclear and attempts to control tics should be paramount. Circumferential fusion with neck bracing represents a viable treatment option.
Authors: Danielle C Cath; Tammy Hedderly; Andrea G Ludolph; Jeremy S Stern; Tara Murphy; Andreas Hartmann; Virginie Czernecki; Mary May Robertson; Davide Martino; A Munchau; R Rizzo Journal: Eur Child Adolesc Psychiatry Date: 2011-04 Impact factor: 4.785
Authors: Jonggil Kim; Ji-Yoon Kim; Ja Myoung Lee; Dong Ho Kang; Chul Hee Lee; In Sung Park; Young Seok Lee Journal: Korean J Neurotrauma Date: 2019-09-18