Modified cervical sympathectomy for treatment of tic disorders with paroxysmal spasm as the main manifestation

Abstract

Objective To evaluate the clinical effects of modified cervical sympathectomy for the treatment of tic disorders (TD) with paroxysmal spasm as the main manifestation and to analyze the feasibility of this method. Methods A total of 20 patients with TD, admitted to Department of Neurosurgery, China-Japan Friendship Hospital from January 2014 to January 2017, were enrolled into this study. All patients received cervical sympathectomy. The severities of TD symptoms were evaluated respectively by Yale Global Tic Severity Scale (YGTSS) in all patients before operation at 1 month and 12 months post operation. Results All patients were followed up for 14-51 months with an average of 25.10±10.25 months. Twenty patients presented 1-month and 12-month postoperative motor tic severity scores of 9.20±3.64 points and 9.25±3.67 points respectively. The 1-month and 12-month postoperative total YGTSS scores were 22.80±15.58 points and 21.65±16.17 points respectively. Compared with preoperative motor tic severity score (19.00±1.17 points) and total YGTSS score (52.90±4.96 points), the 1-month and 12-month postoperative scores showed significant difference (F=68.13, 35.62, respectively, P<0.001). No complications such as hoarseness, choking/coughing while drinking were observed in those 20 patients. Conclusion Modified cervical sympathectomy seems to be a feasible and effective method for the treatment of tic disorders with paroxysmal spasm as the main manifestation with relatively few complications or adverse reactions. Key words: Tic disorders; Sympathectomy; Neck; Treatment outcome