Cervical myelopathy secondary to violent tics of Tourette’s syndrome

Tic disorders are a rarely reported cause of cervical myelopathy.1-4⇓⇓⇓ Cervical myelopathy occurring in association with tics has typically been attributed to damage caused by violent and frequent neck flexion movements4 or twisting and extension movements.2 Cervical spinal cord injury is believed to result from repetitive stretching and compression of the cord or ischemia/hypoxia due to venous congestion.4 Frequent and forceful tics have also been reported to cause spinal cord damage from cervical disk herniation1 and cervical spondylosis.5 The presence of congenital canal stenosis increases this risk.3 We report a young man with violent, repetitive neck flexion due to Tourette’s syndrome who developed a cervical myelopathy. This 25-year-old man presented in September 1999, after 10 days of increasing extremity numbness, burning, and weakness accompanied by occasional muscle spasms, constipation, and urinary frequency. Ten months earlier, he developed paresthesias of all extremities that improved greatly over 3 weeks in the absence of …