Tic modulation using sensory tricks

Abstract

Background: A sensory trick, or geste antagoniste, is defined as a physical gesture (such as a touch on a particular body part) that mitigates the production of an involuntary movement. This phenomenon is most commonly described as a feature of dystonia. Here we present a case of successful modulation of tics using sensory tricks.

Case report: A case report and video are presented. The case and video demonstrate a 19-year-old male who successfully controlled his tics with various sensory tricks.

Discussion: It is underappreciated by movement disorder physicians that sensory tricks can play a role in tics. Introducing this concept to patients could potentially help in tic control. In addition, understanding the pathophysiological underpinnings of sensory tricks could help in the understanding of the pathophysiology of tics.

Keywords: Sensory tricks; Tourette’s syndrome; tics.

Video 1. The patient is able to control the leftward turning of his neck when his baseball cap is on. &SetFont Typeface="12";Other tics such as blinking and left arm movements continue. When the cap is removed, the tics, and the sensory urge to perform them, begin almost immediately. The patient can achieve the same tic relief when he puts his hand along the side of his mouth and when he rests his head on the back of the chair. A bandana also aborts the tics, and they re-emerge as soon as the bandana is removed.