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Título

Functional tic similar to Tourette's syndrome associated with digital media consumption during the Covid-19 Pandemic

RESUMO

Case presentation:
An 15-years-old woman, started body movements six months before the admition in the neurology service, after emotional stress with acutely present complex and diverse movements. After one month, she started nonspecific vocalizations, such as whistling and coprolalia, which worsen with anxiety and presence of self- and hetero-aggressive movements. Such movements can be suggested and get worse if suppressed. She started risperidone and sertraline. Important consumption of digital media. Cranial MRI and electroencephalogram did not show any changes that would justify the condition by secondary causes.
Discussion:
Tics are sudden, rapid and repetitive movements or sounds that are preceded by an urge sensation and can be temporarily suppressed. Motor tics can be clonic, dystonic or tonic movements and vocal tics are projected mostly as irrelevant sounds. The tic can be considered complex with more elaborate movements like kicks, copropraxia, speech of words or phrases, with coprolalia and echolalia. Tourette's Syndrome (TS) occur mostly in the pediatric population and males. Characterized as motor tics and one or more verbal tics present at some point in the disease.
The pandemic caused by Covid-19, there has been an worldwide increase in cases of people between 12 and 25 years old, mostly female, with a rapid onset and development of complex motor or vocal tic-like behaviors, causing emergency department visits, which was named of Functional Tic-like Behaviors (FTLBs). A despite the geographic diversity, most cases shared common denominators, such as exposure to specific content on online media platforms such as TikTok and YouTube. Associated with the content of TS and FTLBs.
As main differences between TS and FTLBs is an absence of progression from initially simple to complex tics; less suppression capacity and presence of psychosocial stressors such as tension between parents or family members, intensified by the lockdown, in addition to a higher prevalence with anxiety disorder or depression.
Final Comments:
Therefore, attention to the symptoms presented and the chronology of the disease are important, in order to avoid the automatic diagnosis of TS in patients with motor and verbal tics and also consider the presence of a functional disorder. In these last cases, modifying inappropriate social media exposures, psychotherapy, and addressing psychiatric disorders such as anxiety and depression can all be considered.

Palavras Chave

Tourette's Syndrome; Functional Tic-like Behaviors; COVID-19 pandemic

Área

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