title: A positive diagnosis of functional (psychogenic) tics.
abstract: OBJECTIVE
  Functional tics, also called psychogenic tics or pseudo-tics, are difficult to diagnose because of the lack of diagnostic criteria and their clinical similarities to organic tics. The aim of the present study was to report a case series of patients with documented functional tics and to describe their clinical characteristics, risk factors and psychiatric comorbidity. Also clinical tips are suggested which might help the differential diagnosis in clinical practice.
  
  
  RESULTS
  Eleven patients (mean age at onset 37.2, SD 13.5; three females) were included with a documented or clinically established diagnosis of functional tics, according to consultant neurologists who have specific expertise in functional movement disorders or in tic disorders. Adult onset, absent family history of tics, inability to suppress the movements, lack of premonitory sensations, absence of pali-, echo- and copro-phenomena, presence of blocking tics, the lack of the typical rostrocaudal tic distribution and the coexistence of other functional movement disorders were common in our patients.
  
  
  CONCLUSIONS
  Our data suggest that functional tics can be differentiated from organic tics on clinical grounds, although it is also accepted that this distinction can be difficult in certain cases. Clinical clues from history and examination described here might help to identify patients with functional tics.
authors.affiliation: Sobell Department, UCL Institute of Neurology, London, UK; Department of Psychiatry, San Paolo Hospital and University of Milan, Milan, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Demartini
authors.forename: L
authors.initials: L
authors.lastname: Ricciardi
authors.forename: I
authors.initials: I
authors.lastname: Parees
authors.forename: C
authors.initials: C
authors.lastname: Ganos
authors.forename: K P
authors.initials: KP
authors.lastname: Bhatia
authors.forename: M J
authors.initials: MJ
authors.lastname: Edwards
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013981:Tic Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology
keywords: functional; psychogenic; tics