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Case Reports
. 2021 May 25;8(5):769-771.
doi: 10.1002/mdc3.13236. eCollection 2021 Jul.

Aggression Toward Others Misdiagnosed as Primary Tics

Lille Kurvits  1 , Tina Mainka  1   2 , Andrea E Cavanna  3   4   5 , Andrea A Kühn  1   6 , Christos Ganos  1
Affiliations
Case Reports

Aggression Toward Others Misdiagnosed as Primary Tics

Lille Kurvits et al. Mov Disord Clin Pract. .

Abstract

Background: Tics describe a wide range of sudden and repetitive behaviors. Their multifaceted clinical features may resemble other explosive behaviors, including repetitive episodes of aggression toward others (allo-aggression) reported by subjects without tics. Here, we document 3 exemplary cases that help disentangle allo-aggressive behaviors from tics.

Cases: We report 3 cases who presented with an array of complex repetitive behaviors, most notably allo-aggression (eg, sudden kicking, hitting, slapping and biting others, or pushing someone off a bike), which were misdiagnosed as primary tics. In all cases, additional symptoms, such as blackouts, feeling of being controlled by different personalities, or being empowered by repetitive behaviors, and examination pointed toward different neuropsychiatric diagnoses.

Conclusions: Repetitive allo-aggressive behaviors are not part of the range of motor manifestations of tics. This observation not only has important medico-legal implications but is also relevant for the overall perception of Tourette syndrome and other primary tic disorders.

Keywords: Tourette syndrome; allo‐aggression; functional neurological symptom disorder; tic disorders.

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Conflict of interest statement

This research project was supported by a grant from the VolkswagenStiftung (Freigeist) held by C.G. T.M. is a participant in the BIH‐Charité Clinician Scientist Program funded by the Charité‐Universitätsmedizin Berlin and the Berlin Institute of Health. The authors disclose no conflicts of interest regarding this manuscript.

References

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