Antoinette Nguyen1, Sean Kuei-Hsin Wang2, Jennifer Vermilion1, Jaclyn Martindale2
1Neurology, University of Rochester, 2Neurology, Atrium Health Wake Forest Baptist
Objective:
To assess the characteristics of patients presenting with functional tics (FT) at two different pediatric neurology sites. A subaim was to assess for differences in presentations of FT between cisgender versus non-binary or transgender youth.
Background:
In the years between 2020 and 2022, coinciding with the COVID-19 pandemic, we have seen a large increase in the incidence of functional tics in adolescents (ages 12-18 years). Understanding how FT differs from tic disorders and whether FT presents differently among gender identity groups may help to better identify FT in individuals.
Design/Methods:
We conducted a systematic chart review at two different sites using the Epic Electronic Medical Record System of the Pediatric Neurology Departments at Strong Memorial Hospital in Rochester, NY (UR) and at Atrium Health Wake Forest Baptist in Winston-Salem, NC (WF).
Results:
There were 83 subjects, 37 of whom were patients at UR and 46 at WF. The average age of onset of FT was 13.6 years old with 5% male, 70% female, 12% transgender female-to-male, 13% nonbinary or gender fluid. At onset, 76% of patients had complex tics, 45% had abusive behavior, 73% had motor tics which localized below the neck, and 55% had contextual or specific triggers to tics. 37% endorsed exposure to tics by social media or peers. The two most common co-occurring conditions were anxiety (69%) and depression (51%). There was no significant difference in phenomenology of FT in cisgender versus non-binary or transgender youth.
Conclusions:
Functional tics were more common in adolescent females and were associated with more complex presentation at onset than tic disorders. There was no significant difference in age of onset, symptomatology, and treatment of FT in cisgender versus non-binary or transgender youth.