A 21-Year-Old Woman with New Onset Tourette Syndrome after Coronavirus Disease 2019 (COVID-19)
Main Article Content
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019 and has affected millions. Many patients who have had coronavirus disease 2019 (COVID-19) infection develop acute and chronic medical illnesses which can impact every organ system. Those who develop new-onset neurological disorders during the acute phase will often experience long-lasting complications. Although the specific cause is unclear, many mechanisms have been cited, including a direct impact from the virus itself and indirect impacts from inflammation, hypoxia, and hypercoagulability. We present a case of an adult with no neurological or psychiatric history who developed a series of neurological issues ending in the development of Tourette Syndrome (TS) after a COVID-19 infection. The patient has continued to display the symptoms of Tourette Syndrome but has improved with the current treatments available for Tourette Syndrome.
Keywords:
Tourette Syndrome; TIC Disorder; COVID-19
Article Details
How to Cite
MUNIPALLI, Bala; MORRIS, Anjali; RUMMANS, Teresa.
A 21-Year-Old Woman with New Onset Tourette Syndrome after Coronavirus Disease 2019 (COVID-19).
Medical Research Archives, [S.l.], v. 12, n. 7, july 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5439>. Date accessed: 05 aug. 2024.
doi: https://doi.org/10.18103/mra.v12i7.5439.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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3. Kohansal Vajari M, Shirin M, Pourbagheri-Sigaroodi A, Akbari ME, Abolghasemi H, Bashash D. COVID-19-related coagulopathy: A review of pathophysiology and pharmaceutical management. Cell Biol Int. 2021 Sep; 45(9):1832-1850. doi: 10.1002/cbin.11623. Epub 2021 May 16. PMID: 33945651; PMCID: PMC8239905.
4. Schneider SA, Hennig A, Martino D. Relationship between COVID-19 and movement disorders: A narrative review. Eur J Neurol. 2022 Apr; 29(4):1243-1253. doi: 10.1111/ene.15217. Epub 2021 Dec 31. PMID: 34918437.
5. Ray STJ, Abdel-Mannan O, Sa M, Fuller C, Wood GK, Pysden K, Yoong M, et al. Neurological manifestations of SARS-CoV-2 infection in hospitalised children and adolescents in the UK: a prospective national cohort study. Lancet Child Adolesc Health. 2021 Sep; 5(9):631-641. doi: 10.1016/S2352-4642(21)00193-0. Epub 2021 Jul 15. Erratum in: Lancet Child Adolesc Health. 2021 Sep; 5(9):e38. doi: 10.1016/S2352-4642(21)00238-8. Erratum in: Lancet Child Adolesc Health. 2021 Dec; 5(12):e46. doi: 10.1016/S2352-4642(21)00331-X. PMID: 34273304; PMCID: PMC8279959.
6. Paterson RW, Brown RL, Benjamin L, Nortley R, Wiethoff S, Bharucha T, Jayaseelan DL, et al. The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings. Brain. 2020 Oct 1; 143(10):3104-3120. doi: 10.1093/brain/awaa240. PMID: 32637987; PMCID: PMC7454352.
7. Efstathiou V, Stefanou MI, Demetriou M, Siafakas N, Makris M, Tsivgoulis G, Zoumpourlis V, et al. Long COVID and neuropsychiatric manifestations (Review). Exp Ther Med. 2022 May; 23(5):363. doi: 10.3892/etm.2022.11290. Epub 2022 Apr 1. PMID: 35493431; PMCID: PMC9019760.
8. Ryan MC, Liang H, Wilson E, Levine A, Kottilil S, Ernst T, Chang L. Quantifying the Neuropsychiatric Symptoms in Post-Acute Sequelae of COVID-19 (PASC) using the NIH Toolbox® and PROMIS. NeuroImmune Pharm Ther. 2023 Jun 20; 2(2):95-101. doi: 10.1515/nipt-2022-0010. Epub 2022 Aug 15. PMID: 37502462; PMCID: PMC10373798.
9. McGuire JF, Bennett SM, Conelea CA, Himle MB, Anderson S, Ricketts EJ, Capriotti MR, et al. Distinguishing and Managing Acute-Onset Complex Tic-like Behaviors in Adolescence. J Am Acad Child Adolesc Psychiatry. 2021 Dec; 60(12): 1445-1447. doi: 10.1016/j.jaac.2021.07.823. Epub 2021 Aug 12. PMID: 34391859; PMCID: PMC10895863.
10. Johnson KA, Worbe Y, Foote KD, Butson CR, Gunduz A, Okun MS. Tourette syndrome: clinical features, pathophysiology, and treatment. Lancet Neurol. 2023 Feb; 22(2):147-158. doi: 10.1016/S1474-4422(22)00303-9. Epub 2022 Oct 28. PMID: 36354027; PMCID: PMC10958485.
11. Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, Chang J, Hong C, Zhou Y, Wang D, Miao X, Li Y, Hu B. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020 Jun 1; 77(6):683-690. doi: 10.1001/jamaneurol.2020.1127. PMID: 32275 288; PMCID: PMC7149362.
12. Alexopoulos H, Magira E, Bitzogli K, Kafasi N, Vlachoyiannopoulos P, Tzioufas A, Kotanidou A, Dalakas MC. Anti-SARS-CoV-2 antibodies in the CSF, blood-brain barrier dysfunction, and neurological outcome: Studies in 8 stuporous and comatose patients. Neurol Neuroimmunol Neuroinflamm. 2020 Sep 25; 7(6):e893. doi: 10.1212/NXI.00000 00000000893. PMID: 32978291; PMCID: PMC757 7546.
13. Tandon M, Kataria S, Patel J, Mehta TR, Daimee M, Patel V, Prasad A, Chowdhary AA, Jaiswal S, Sriwastava S. A Comprehensive Systematic Review of CSF analysis that defines Neurological Manifestations of COVID-19. Int J Infect Dis. 2021 Mar; 104:390-397. doi: 10.1016/ j.ijid.2021.01.002. Epub 2021 Jan 9. PMID: 3343 4662; PMCID: PMC7837002.
14. Michael, B.D., Dunai, C., Needham, E.J. et al. Para-infectious brain injury in COVID-19 persists at follow-up despite attenuated cytokine and autoantibody responses. Nat Commun. 2023; 14: 8487. https://doi.org/10.1038/s41467-023-42320-4.
15. Hassan M, Syed F, Ali L, Rajput HM, Faisal F, Shahzad W, Badshah M. Chorea as a Presentation of SARS-CoV-2 Encephalitis: A Clinical Case Report. J Mov Disord. 2021 Sep; 14(3):245-247. doi: 10.14 802/jmd.20098. Epub 2021 Mar 15. PMID: 337064 77; PMCID: PMC8490192.
16. Maury A, Lyoubi A, Peiffer-Smadja N, de Broucker T, Meppiel E. Neurological manifestations associated with SARS-CoV-2 and other coronaviruses: A narrative review for clinicians. Rev Neurol (Paris). 2021 Jan-Feb; 177(1-2):51-64. doi: 10.1016/j.neur ol.2020.10.001. Epub 2020 Dec 16. PMID: 334463 27; PMCID: PMC7832485.
17. Taquet M, Geddes JR, Husain M, Luciano S, Harrison PJ. 6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records. Lancet Psychiatry. 2021 May; 8(5):416-427. doi: 10.1016/S2215-0366(21)00084-5. Epub 2021 Apr 6. PMID: 33836148; PMCID: PMC8023694.
18. Horner O, Hedderly T, Malik O. The changing landscape of childhood tic disorders following COVID-19. Paediatr Child Health (Oxford). 2022 Oct; 32(10):363-367. doi: 10.1016/j.paed.2022.07. 007. Epub 2022 Aug 9. PMID: 35967969; PMCID: PMC9359930.
19. Buts S, Duncan M, Owen T, Martino D, Pringsheim T, Byrne S, McWilliams A, et al. Paediatric tic-like presentations during the COVID-19 pandemic. Arch Dis Child. 2022 Mar; 107(3):e17. doi: 10.1136/archdischild-2021-323002. Epub 2021 Nov 25. PMID: 34824091.
20. Harris E. Brain Inflammation May Underlie Neuropsychiatric Symptoms of Dementia. JAMA. 2024 Jan 16; 331(3):190. doi: 10.1001/jama.2023.2 5768. PMID: 38150219.
21. Fisicaro F, Di Napoli M, Liberto A, Fanella M, Di Stasio F, Pennisi M, Bella R, Lanza G, Mansueto G. Neurological Sequelae in Patients with COVID-19: A Histopathological Perspective. Int J Environ Res Public Health. 2021 Feb 3; 18(4):1415. doi: 10.3390/ijerph18041415. PMID: 33546463; PMCID: PMC7 913756.