Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
Department of Sciences and Engineering, University of Guanajuato, Ave León 428, Jardines del Moral, C.P. 37320, León, Guanajuato, México.
J Neurol. 2022 Oct;269(10):5312-5318. doi: 10.1007/s00415-022-11174-z. Epub 2022 May 14.
Dystonic tics differ from clonic tics by their slower and more sustained nature. Dystonic tics are often present in patients with Tourette syndrome (TS) and other tic-disorders. However, their phenomenology and impact on overall impairment have not been extensively studied.
We assessed clinical history and tic duration in video-recordings from patients with TS evaluated at our movement disorders clinic. Dystonic tics were defined as those lasting ≥ 1000 ms (ms).
Of the total of 201 patients with TS, there were 156 with video-recordings suitable for tic duration analysis, of their tics, 57 (36.5%) of whom had dystonic motor tics, including 9 (5.7%) with dystonic phonic tics. Dystonic motor tics had a duration range between 1033 and 15,000 ms and dystonic phonic tics between 1132 and 17,766 ms. Patients with dystonic tics were older 24.4 vs. 16.5 years (P = 0.005) and had an older age at onset 12.9 vs. 7.2 years (P < 0.001), than patients without dystonic tics. The bivariate analysis showed an association between the presence of dystonic tics, greater tic severity and wider body distribution. The multivariate regression analysis showed a statistical association with older age at evaluation (P = 0.001), greater tic severity on video-recordings (P = 0.001) and co-occurrence with complex motor tics (P = 0.020). The presence of dystonic tics increased the risk for being considered for deep brain stimulation therapy, odds ratio: 15.7 (P = 0.002).
Dystonic tics, observed in about a third of patients with TS, are associated with increased severity of TS.
与阵挛性抽搐不同，肌张力障碍性抽搐的特点是发作较慢且持续时间较长。肌张力障碍性抽搐常见于妥瑞氏综合征（TS）和其他抽搐障碍患者中。然而，其临床表现和对整体损伤的影响尚未得到广泛研究。
我们评估了在我们的运动障碍诊所接受评估的 TS 患者的视频记录中的临床病史和抽搐持续时间。将持续时间≥1000ms（ms）的抽搐定义为肌张力障碍性抽搐。
在总共 201 名 TS 患者中，有 156 名患者的视频记录适合进行抽搐持续时间分析，其中 57 名（36.5%）患者存在肌张力障碍性运动性抽搐，包括 9 名（5.7%）患者存在肌张力障碍性发音性抽搐。肌张力障碍性运动性抽搐的持续时间范围为 1033 至 15000ms，肌张力障碍性发音性抽搐的持续时间范围为 1132 至 17766ms。存在肌张力障碍性抽搐的患者年龄较大（24.4 岁比 16.5 岁，P=0.005），发病年龄也较大（12.9 岁比 7.2 岁，P<0.001）。 二变量分析显示，存在肌张力障碍性抽搐与抽搐严重程度较高和躯体分布范围较广有关。多元回归分析显示，与评估时的年龄较大（P=0.001）、录像中抽搐严重程度较高（P=0.001）以及与复杂运动性抽搐共发（P=0.020）存在统计学关联。存在肌张力障碍性抽搐会增加被考虑接受深部脑刺激治疗的风险，优势比为 15.7（P=0.002）。
在约三分之一的 TS 患者中观察到的肌张力障碍性抽搐与 TS 严重程度增加有关。
