Factor S A, Molho E S
Department of Neurology, Albany Medical College, NY 12208, USA.
Mov Disord. 1997 Nov;12(6):1052-5. doi: 10.1002/mds.870120634.
We report the cases of two patients with adult-onset, simple, nonvarying tic disorder that commenced after a peripheral (non-CNS) injury. The first patient is a 38-year-old man who suffered a right facial injury when his car fell off its jack while he was working underneath. Bilateral facial twitching began hours after the trauma and was characterized as a sniffinglike gesture. The movements waxed and waned, were suppressible, and were associated with a premonitory sensation. The tics remitted after 9 months but still recur occasionally under stressful situations. The second patient is a 34-year-old man with a 3-year history of abrupt, rapid head-turning movements that began 12 months after a motor vehicle accident in which he injured his neck. The tics continue to wax and wane, are suppressible, and are associated with an urge. Neither patient suffered a head injury or had a family history of Tourette syndrome. Based on the clinical and historical features of these patients, the temporal relationship between the trauma and onset of tics, and the occurrence of tics only in the traumatized region, a causal relationship is possible. These may represent the first reported cases of tic disorder in association with peripheral injury. The mechanism by which the tic disorder resulted from the peripheral injury is unclear, but these patients might have been susceptible individuals and the trauma acted as a trigger.
我们报告了两例成年起病的简单、无变化性抽动障碍患者的病例，这些抽动障碍在周围（非中枢神经系统）损伤后开始出现。首例患者是一名38岁男性，他在车下作业时千斤顶滑落，导致右面部受伤。创伤后数小时开始出现双侧面部抽搐，表现为类似吸气的动作。这些动作时有时无，可被抑制，并伴有一种先兆感觉。抽动在9个月后缓解，但在压力情况下仍偶尔复发。第二例患者是一名34岁男性，有3年突然快速转头动作的病史，这些动作在他颈部受伤的机动车事故12个月后开始出现。抽动仍然时有时无，可被抑制，并伴有冲动感。两名患者均未遭受头部损伤，也没有抽动秽语综合征的家族史。基于这些患者的临床和病史特征、创伤与抽动发作之间的时间关系以及抽动仅发生在受伤部位，两者之间可能存在因果关系。这些可能是首次报道的与周围损伤相关的抽动障碍病例。周围损伤导致抽动障碍的机制尚不清楚，但这些患者可能是易感个体，创伤起到了触发作用。
