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Adult-onset tic disorder, motor stereotypies, and behavioural disturbance associated with antibasal ganglia antibodies

Authors

  • Mark J. Edwards MBBS,

    1. Sobell Department of Movement Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London, United Kingdom
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  • Russell C. Dale MBBS,

    1. Neuroimmunology unit, Department of Neuroinflammation, Institute of Neurology, University College London, Queen Square, London, United Kingdom
    2. Neurosciences unit, Institute of Child Health, London, United Kingdom
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  • Andrew J. Church PhD,

    1. Neuroimmunology unit, Department of Neuroinflammation, Institute of Neurology, University College London, Queen Square, London, United Kingdom
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  • Eleni Trikouli MD,

    1. Sobell Department of Movement Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London, United Kingdom
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  • Niall P. Quinn MD,

    1. Sobell Department of Movement Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London, United Kingdom
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  • Andrew J. Lees MD,

    1. The Reta Lila Weston Institute of Neurological Studies, The Windeyer Building, London, United Kingdom
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  • Gavin Giovannoni PhD,

    1. Neuroimmunology unit, Department of Neuroinflammation, Institute of Neurology, University College London, Queen Square, London, United Kingdom
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  • Kailash P. Bhatia MD

    Corresponding author
    1. Sobell Department of Movement Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London, United Kingdom
    • Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK
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Abstract

The onset of tics in adulthood is rare and, unlike the childhood variety, there is commonly a secondary environmental cause. We present four cases (1 man, 3 women) with an adult onset tic disorder (mean age of onset, 36 years; range, 27–42 years) associated with the presence of serum antibasal ganglia antibodies (ABGA). One patient had motor tics and unusual motor stereotypies, 2 had multiple motor and vocal tics, and the remaining patient had motor tics only. Concomitant psychiatric disturbance was noted in 3 cases. In 2 cases, there was a close temporal relationship between upper respiratory tract infection and the subsequent onset of tics. Imaging was possible in three cases and was normal in two but revealed a lesion involving the right caudate and lentiform nuclei in the other. We suggest that there might be a causal relationship between ABGA and the clinical syndrome in these cases and that ABGA should be considered as a possible etiology for adult-onset tics. © 2004 Movement Disorder Society

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