title: Tics after traumatic brain injury.
abstract: BACKGROUND
  Tics are involuntary non-rhythmic, stereotyped muscle contractions which can be suppressed temporarily. Tics usually start during childhood as part of Tourette syndrome. Adult onset tics are infrequent. This study reports on an adult man who developed tics 1 year after severe traumatic brain injury (TBI).
  
  
  METHODS
  Case report and review of literature.
  
  
  RESULTS
  A 19-year-old man sustained TBI following a road traffic accident. He did not have tics or features of obsessive compulsive disorder before the brain injury. A year after injury he developed motor and vocal tics. Magnetic resonance image of the brain showed lesions in the basal ganglia. A search of databases Medline, EMBASE and CINHAL found only four publications on tics in adults with TBI. None of these reported cases had lesions in the basal ganglia.
  
  
  CONCLUSIONS
  Tics are a rare complication of TBI. People with early onset post-traumatic tics may have had a previously unrecognized, mild tic disorder or a genetic predisposition for tics, which was unmasked by the TBI. In contrast, late post-traumatic tics could be due to delayed effects of injury on neural circuits connecting the frontal cortex and basal ganglia.
authors.affiliation: Sheffield Teaching Hospitals NHS Trust, UK.
authors.forename: Nishant
authors.initials: N
authors.lastname: Ranjan
authors.forename: Krishnan Padmakumari Sivaraman
authors.initials: KP
authors.lastname: Nair
authors.forename: Charles
authors.initials: C
authors.lastname: Romanoski
authors.forename: Rajiv
authors.initials: R
authors.lastname: Singh
authors.forename: Guruprasad
authors.initials: G
authors.lastname: Venketswara
mesh_terms: D000328:Adult; D001479:Basal Ganglia; D001930:Brain Injuries / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013064:Speech Disorders / Q000209:etiology*; D013981:Tic Disorders / Q000209:etiology*