title: Tics as signs of catatonia: electroconvulsive therapy response in 2 men.
abstract: OBJECTIVE
  Tics have rarely been described in catatonia although tics are sudden and nonrhythmic variants of stereotypic or repetitive movement abnormalities that are considered cardinal symptoms of catatonia. We describe 2 men with tics and self-injurious behavior, who met criteria for catatonia. One patient met criteria for autism.
  
  
  METHODS
  We reported 2 new cases and performed a literature review using PubMed to identify other cases of tics that were treated with electroconvulsive therapy. Tics along with other catatonic symptoms and self-injurious behavior responded to electroconvulsive therapy in 2 men. Eight other patients with tics that were treated with electroconvulsive therapy were found in the literature. Catatonia was recognized in 4 of the 8 patients. Two patients met criteria for autism.
  
  
  CONCLUSIONS
  Tics, with or without self-injurious behavior, may be signs of catatonia. Patients with tics or Tourette syndrome warrant assessment for catatonia. If catatonia is present, electroconvulsive therapy provides a safe but rarely used alternative to pharmacotherapy, psychosurgery, or invasive brain stimulation in the treatment of tics and Tourette syndrome.
authors.affiliation: Department of Psychiatry, University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216, USA. dr6340451@pol.net
authors.forename: Dirk M
authors.initials: DM
authors.lastname: Dhossche
authors.forename: Irving M
authors.initials: IM
authors.lastname: Reti
authors.forename: Shashidhar M
authors.initials: SM
authors.lastname: Shettar
authors.forename: Lee E
authors.initials: LE
authors.lastname: Wachtel
mesh_terms: D000293:Adolescent; D001321:Autistic Disorder / Q000150:complications; D002389:Catatonia / Q000150:complications* / Q000628:therapy*; D003863:Depression / Q000150:complications / Q000523:psychology / Q000628:therapy; D004565:Electroconvulsive Therapy; D006801:Humans; D008297:Male; D012008:Recurrence; D016728:Self-Injurious Behavior / Q000628:therapy; D020323:Tics / Q000209:etiology*; D005879:Tourette Syndrome / Q000523:psychology / Q000628:therapy; D055815:Young Adult