Tics as Signs of Catatonia: Electroconvulsive Therapy... : The Journal of ECT (original) (raw)

Case Reports

Electroconvulsive Therapy Response in 2 Men

Dhossche, Dirk M. MD, PhD*; Reti, Irving M. MBBS†; Shettar, Shashidhar M. MD*; Wachtel, Lee E. MD‡

From the *Department of Psychiatry, University of Mississippi Medical Center, Jackson, MS; †Department of Psychiatry and ‡Kennedy Krieger Institute, Johns Hopkins School of Medicine, Baltimore, MD.

Received for publication October 3, 2009; accepted November 7, 2009.

Reprints: Dirk M. Dhossche, MD, PhD, Department of Psychiatry, University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216 (e-mail: [email protected]).

No financial support was received for the study.

The authors have no proprietary or commercial interest in the study.

Abstract

Objectives:

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.

Case Reports:

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.