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Attenuation of Apparent New-Onset Ocular Tics with Successful Treatment of PTSD

Published online by Cambridge University Press:  07 November 2014

Patrick C. Hayes ,
Charles L. Weber ,
Michael B. Gallagher  and
Gary J. Drouillard
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Abstract

This case report describes a patient with reportedly new onset of tics, beginning at 21 years of age, in the context of posttraumatic stress disorder (PTSD) and comorbid alcohol abuse, with no known head injury. The setting is an American Society of Addiction Medicine intensive outpatient substance abuse rehabilitation program in an United States Army Medical Center. The patient is a 22-year-old male diagnosed with alcohol abuse and delayed PTSD who presented to the program's medical officer due to insomnia. We discovered he had a reportedly new ocular tic of ∼9 months duration, which he claimed developed at 21 years of age soon after returning from 1 year of combat duty. The patient was thoroughly evaluated, and we surmised the tic was a symptom of PTSD. After achieving full remission from alcohol, the tic persisted. However, as his PTSD symptoms remitted, so did his tic symptoms. At 6-month follow-up, the patient reported he was essentially free from PTSD symptoms, and his tic was significantly reduced.

Type
Case Report
Information
CNS Spectrums , Volume 14 , Issue 4 , April 2009 , pp. 214 - 220
Copyright
Copyright © Cambridge University Press 2009

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References

REFERENCES

1.Altindag, A, Yanik, M, Asoglu, M. The emergence of tics during escitalopram and sertraline treatment. Int Clin Psychopharmacol. 2005;20:177–178.CrossRefGoogle ScholarPubMed
2.Diagnostic and Statistical Manual of Mental Disorders. 4th ed, text rev. Washington, DC: American Psychiatric Assiocation; 2000.Google Scholar
3.Bryant, RA, Harvey, AG, Gordon, E, Barry, RJ. Eye movement and electrodermal responses to threat stimuli in post-traumatic stress disorder. Int J Psychophysiol. 1995;20:209–213.CrossRefGoogle ScholarPubMed
4.Buckley, TC, Kaloupek, DG. A meta-analytic examination of basal cardiovascular activity in posttraumatic stress disorder. Psychosom Med. 2001;63:585–594.Google Scholar
5.Cerbone, A, Sautter, FJ, Manguno-Mire, G, et al.Differences in smooth pursuit eye movement between posttraumatic stress disorder with secondary psychotic symptoms and schizophrenia. Schizophr Res. 2003;63:59–62.Google Scholar
6.Cohen, ML, Quintner, JL. The derailment of railway spine: a timely lesson for posttraumatic fibromyalgia syndrome. Pain Reviews. 1996;3:181–202.Google Scholar
7.Combs, DE. EMDR Controversial. Available at: http://www.geocities.com/Heartland/Valley/9078/links.html. Accessed May 3, 2006.Google Scholar
8.Cunningham, M, Cunningham, K, Lydiard, RB. Eye tics and subjective hearing impairment during fluoxetine therapy. Am J Psychiatry. 1990;147:947–948.Google ScholarPubMed
9.Ewing, JA. Detecting alcoholism. The CAGE questionnaire. JAMA. 1984;252:1905–1907.Google Scholar
10.Factor, SA, Molho, ES. Adult-onset tics associated with peripheral injury. Mov Disord. 1997;12:1052–1055.Google Scholar
11.Fennig, S, Fennig, SN, Pato, M, Weitzman, A. Emergence of symptoms of Tourette's syndrome during fluvoxamine treatment of obsessive-compulsive disorder. Br J Psychiatry. 1994;164:839–841.CrossRefGoogle ScholarPubMed
12.Frasier, F, Wilson, RM. The sympathetic nervous system and the “irritable heart of soldiers.” BMJ. 1918;13:27–29.Google Scholar
13.Friedman, EH. The neurobiology of posttraumatic stress disorder (PTSD). Biol Psychiatry. 1994;35:500.Google Scholar
14.Gaul, JJ. Posttraumatic tic disorder. Mov Disord. 1994;9:121.Google ScholarPubMed
15.Grillon, C, Morgan, CA 3rd. Fear-potentiated startle conditioning to explicit and contextual cues in Gulf War veterans with posttraumatic stress disorder. J Abnorm Psychol. 1999;108:134–142.Google Scholar
16.Hassard, A. Reverse learning and the physiological basis of eye movement desensitization. Med Hypotheses. 1996;47:277–282.CrossRefGoogle ScholarPubMed
17.Hauser, RA. Zesiewicz, TA. Sertraline-induced exacerbation of tics in Tourette's syndrome. Mov Disord. 1995;10:682–684.Google Scholar
18.Kingsbury, A. The life and death of a soldier/one soldier's story. U.S. News and World Report. May 21, 2007. Volume 142, number 18. Pages 39–45.Google Scholar
19.Kumar, A, Balan, S. Fluoxetine for persistent developmental stuttering. Clin Neuropharmacol. 2007;30:58–59.Google Scholar
20.Kumar, R. Lang AE. Tourette syndrome. Secondary tic disorders. Neurol Clin. 1997;15:309–331.CrossRefGoogle ScholarPubMed
21.Lenti, C. Movement disorders associated with fluvoxamine. J Am Acad Child Adolesc Psychiatry. 1999;38:942–943.CrossRefGoogle ScholarPubMed
22.McFarlane, AC, Weber, DL, Clark, CR. Abnormal stimulus processing in posttraumatic stress disorder. Biol Psychiatry. 1993;34:311–320.Google Scholar
23.Meakins, JC, Wilson, RM. The effect of certain sensory stimulations on respiratory and heart rate in cases of so-called. “irritable heart”. Heart. 1918;7:17–22.Google Scholar
24.Orr, SP, Metzger, LJ, Pitman, RK. Psychophysiology of post-traumatic stress disorder. Psychiatr Clin North Am. 2002;25:271–293.Google Scholar
25.Pitman, RK, Orr, SP, Shalev, AY, Metzger, LJ, Mellman, TA. Psychophysiological alterations in post-traumatic stress disorder. Semin Clin Neuropsychiatry. 1999;4:234–241.Google ScholarPubMed
26.Ranjan, S, Sawhney, V, Chandra, PS. Persistent developmental stuttering: treatment with risperidone. Aust N Z J Psychiatry. 2006;40:193.Google Scholar
27.Ross, RJ, Ball, WA, Dinges, DF, et al.Motor dysfunction during sleep in posttraumatic stress disorder. Sleep. 1994;17:723–732.Google Scholar
28.Rüth, U, Mayer-Rosa, J, Schlamp, D, Freisleder, FJ. Tourette's syndrome and antidepressant therapy: exacerbation of nervous tics with paroxetine [German]. Z Kinder Jugendpsychiatr Psychother. 2000;28:105–108.Google Scholar
29.Siemers, E, Pascuzzi, R. Posttraumatic tic disorder. Mov Disord. 1990;5:183.Google Scholar
30.Singer, C, Sanchez-Ramos, J, Weiner, WJ. A case of post-traumatic tic disorder. Mov Disord. 1989;4:342–344.Google Scholar
31.Stickgold, R. EMDR: a putative neurobiological mechanism of action. J Clin Psychol. 2002;58:61–75.Google Scholar
32.Vasterling, JJ, Proctor, SP, Amoroso, P, Kane, R, Heeren, T, White, RF. Neuropsychological outcomes of army personnel following deployment to the Iraq war. JAMA. 2006;296:519–530.Google Scholar