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MOTOR VERSUS VOCAL TICS
  1. AY Omar,
  2. JS Stern,
  3. H Simmons,
  4. M Robertson

Abstract

Objective Some patients with Tourette syndrome present with predominant motor or vocal tics rather than a more balanced combination. We looked at the distribution of the two tic types in a large cohort and also at the clinical characteristics of outliers. The aim was to compare the balance of motor and phonic tics in Tourette's syndrome patient and to assess whether having a significant difference between the motor and phonic tics has any effect on co-morbidity.

Method The Yale Global Tic Severity Scale (YGTSS) scores of 315 patients taken at first visit were reviewed and motor and vocal tic scores plotted graphically. A visual cut-off for outliers with unbalanced tic severities was selected as a difference of 9 or more points.

Results 31 patients had predominantly motor tics with a range of severity, 2 had more vocal tics and the remaining 282 were considered “balanced”. There was a trend to reduced rate of ADHD in the predominant motor group (p=0.054). Values for the YGTSS impairment component were equally spread in the unbalanced group.

Conclusion Most patients have fairly balanced motor and vocal tics, unbalanced presentations seem far more likely to be motor than vocal and the trend to less ADHD in this situation may relate to the gradient of comorbidity rates in TS compared to chronic vocal and chronic motor tics seen in epidemiological samples which are lower for motor tics.

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