Recurrence of childhood multiple tic in late adult life
H. L. Klawans and A. Barr
In contrast to the lifelong persistence of symptoms characteristic of
Gilles de la Tourette's syndrome, multiple tic of childhood is considered
to be a self-limited disorder that remits by early adulthood. We describe
four patients who had a history of multiple tic of childhood, complete
absence of tics throughout most of their adult lives, and recurrence of
tics in late adult life. All four had multiple tics that began before the
age of 9 years and included both motor and vocal tics that changed in
location and severity over time. None of the patients exhibited coprolalia.
All tics subsided before the age of 20 years, only to recur after the age
of 60 years, once again including both motor and vocal tics that changed in
location and severity slowly over time. The one patient who was severely
bothered by the recurrence of motor and vocal tics responded well to
haloperidol. Although they do not fit into any accepted diagnostic category
for multiple tic, these patients suggest that multiple tic of childhood can
recur in adult life. This suggests that Gilles de la Tourette's syndrome
may be a continuum for chronic multiple tic of childhood to full-blown
classic Gilles de la Tourette's syndrome.
