Remission of Gilles de la Tourette syndrome after heat-induced dehydration
File(s)2329-9096-6-472.pdf (318.46 KB)
Published version
Author(s)
Type
Journal Article
Abstract
Heat has been reported to exert variable effects on people with Gilles de la Tourette syndrome (TS). At age 24 years, a 32-year-old right-handed man with TS experienced a marked reduction in tics for two years after undergoing dehydration by entering a hot tub at 103°F (39.4°C) to 104°F (40.0°C) for 3 to 4 hours. On the Yale Global Tic Severity Scale (YGTSS) he scored 55 seven months before dehydration and 13 one month after dehydration. An intense heat exposure and dehydration led to an apparent remission in tics. The remission continued without the use of prescribed or nonprescribed medications or substances for two years until tics returned in the worst ever exacerbation after a tetanus immunization. The heat exposure may have altered at least temporarily his thermostat for normal heat-loss mechanisms through dopaminergic pathways from the anterior hypothalamus to the basal ganglia and the substantia nigra. Whether or not that mechanism or some other mechanism relevant to the heat exposure and/or dehydration is at play, the sudden and marked improvement in his tics needs further attention. Prospective testing of the heat and dehydration effect on tics should be pursued.
Date Issued
2018-06-13
Date Acceptance
2018-06-11
Citation
International Journal of Physical Medicine & Rehabilitation, 2018, 6 (3)
ISSN
2329-9096
Publisher
OMICS
Journal / Book Title
International Journal of Physical Medicine & Rehabilitation
Volume
6
Issue
3
Copyright Statement
©2018 Robert Brašić J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30090843
Subjects
Basal ganglia
Dopamine
Hypothalamus
Substantia nigra
Thermoregulation
Thermostat
Tics
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2018-06-13