Myelopathy caused by tics in an adolescent, associated with T2 signal intensity changes of the spinal cord.

COURSE: A 15-year-old boy who had suffered motor tics since age 9 developed progressive cervical myelopathy involving both his hands and his lower extremities. T2-weighted MRI revealed mild canal stenosis and increased signal intensity in the cervical spinal cord beginning at the C-4 level and continuing upward to the medulla oblongata.

TREATMENT: After C-3 to C-7 laminoplasty, the patient's clinical symptoms improved.

DISCUSSION: It is possible that movement disorders such as tics may contribute to the development of cervical myelopathy owing to the effects of involuntary movements on the neck. Such an intensity change on a T2-weighted image has never been reported in an adolescent tic disorder. Despite such changes, surgical treatment may bring about clinical improvement.