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Question 49: I am wondering if you know of any information you have regarding hits to the head of a person with TS. Twice now M. has been hit hard in hockey(no concussion to the head) and it almost seems that his ticks have gotten worse after the accident. Do you know if there has been any research in this area - is this possible? He was hit about 3 weeks ago and before that he had hardly ticked, he was happy and now he is ticking has increased and his volume and energy level has gone up and gets frustrated easily. Could there be a relation or am I way out in left field?! Yours Truly, J.S., MB, Canada.

Good Morning J.S.

I am currently working with teens who have suffered brain injuries -- some traumatic, some as a result of infections, tumours, and cerebrovascular accidents (CVA's). It is not at all uncommon for brain injury (which can occur without loss of consciousness) to exacerbate existing symptoms of WHATEVER diagnosis (or even personality trait) that the individual had previously.

It is also not unusual for individuals with brain trauma to develop tics as a result of the injury. On a simplistic level, if you think of a Touretter's brain as having "leaky brakes", then one might expect ANY additional strain on the system to cause those brakes to "leak" that much more.

While I would be leery to suggest that a blow to the head without concussion or loss of consciousness could be severe enough to elicit tics in an individual without TS, it does not seem outside the realm of possibility for such an incident to exacerbate existing symptoms. IF this is indeed what has happened, then the waxing of symptoms would likely be temporary (bruising of the brain - called a contusion - of a slight nature does heal).

Before accepting any one explanation, however, one should always first eliminate all other possibilities - are there any other stresses or strains (physical or psychological) that have either appeared or intensified in these past 3 weeks for instance?

I hope this helps! Take care........

Dr. Dunc.

 

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