Tics are neuropsychiatric events characterized by brief, rapid motor movements or vocalizations in response to irresistible premonitory urges. They start in childhood and may or may not persist in adulthood. Adulthood-onset tics are usually an extinction of undiagnosed tics in childhood. Secondary tic disorders may be due to brain tumors, medications, or neurological disorders. In this article, we are describing a woman in her 60s who presented with a new-onset vocal tic a few years after being diagnosed with gluteal sarcoma that metastasized to the lung and brain, involving the left temporal and right occipital lobes. This case is similar to previously reported case reports of secondary tic disorders, although the type of tic, the brain region involved, and the primary tumors are different.

Vocal tics can occur in neuropsychiatric disorders and result in familial distress. Management is challenging, particularly in children with developmental delay. A 5-year-old with cerebral dysgenesis presented with a high amplitude, high-frequency vocal tic. Type II thyroplasty with bilateral cricothyroid muscle myectomy was performed after initial botulinum toxin trial. Amount, volume, and pitch of tics significantly decreased, without change in swallow. Benefits persisted at 1-year follow-up. This is the first description of combined type II thyroplasty with cricothyroid myectomy for high-frequency vocal tic. This can be done safely and provide sustained benefit for a rare, impactful voice disorder.

Allergic rhinitis is the most common allergic disease. It can accompany psychological disorders such as tic disorders due to the prolonged course of the symptoms of allergic rhinitis. This pioneer case-control study aims to investigate tic disorders in children and adolescents under 18 years of age diagnosed with allergic rhinitis.
The case group in this study consisted of patients who had both allergic rhinitis and tic disorders. Patients with allergic rhinitis without tic disorders were also enrolled as the control group with matched gender and age. Demographic characteristics, tic classifications, and contributing factors for allergic rhinitis and tic disorders were studied among the cases. Tic disorders were evaluated using DSM-5 criteria for the classification of tic disorders.
47 patients in the case group and 47 patients in the control group were included in this study. 53.2% and 46.8% were males and females in the case group, respectively. The mean age of the patients was 10.46 ± 3.97 years old. Sound tics were more common among the patients compared to motor tics. Patients with concomitant AR and tic disorders had more days per week with AR symptoms (P-value ≤ 0.001; OR (every day vs. three days a week = 11.02(2.98, 40.76))). Most patients with sound tick were women (p: 0.026), and most patients with motion tic were in the Provisional tic disorder group (p: 0.001). The history of infantile eczema was seen more in patients without sound tic (p: 0.025), and otitis media was significantly less common among patients with sound tics (p: 0.026). Provisional tic disorder was the most common class among the patients. In the case group (coexistence between allergic rhinitis and tic) compared to the control group, patients had significantly more days with AR symptoms per week.
This preliminary study indicates that Provisional tic disorder was the most common classification of tic among patients with allergic rhinitis, especially in patients with motor tics. Asthma in motor tics, a history of food allergy in infancy, and a history of infantile eczema were also common among patients with vocal tics. Also, patients with allergic rhinitis and tic had more severe disease (more symptoms per week) than those with rhinitis alone. These findings emphasize the association of tic disorders with immunological pathways.

Tourette syndrome (TS) is a disorder of the nervous system that causes motor and vocal tics. Tics occur as sudden onset, rapid stereotyped purposeless movements or sounds. Combination therapies can be utilized for adequate control of motor and vocal tics. Patients diagnosed with TS and treated with aripiprazole and guanfacine from 2011-2022 at Saint Louis University Hospital were retrospectively surveyed. Three patients with TS treated with aripiprazole and guanfacine experienced significant improvement or complete resolution of their motor and vocal tics. In our cohort of three patients, the combination of guanfacine and aripiprazole significantly improved or resolved motor and vocal tics that were previously poorly controlled on other traditional medications.