Frontiers in Neurology (Jan 2023)

Rapid onset of functional tic-like behaviors among adolescent girls—Minnesota, September–November 2021

  • Melanie J. Firestone,
  • Melanie J. Firestone,
  • Stacy Holzbauer,
  • Stacy Holzbauer,
  • Christine Conelea,
  • Richard Danila,
  • Kirk Smith,
  • Rebecca H. Bitsko,
  • Susan M. Klammer,
  • Stefan Gingerich,
  • Ruth Lynfield

DOI
https://doi.org/10.3389/fneur.2022.1063261
Journal volume & issue
Vol. 13

Abstract

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BackgroundOn October 15, 2021, the Minnesota Department of Health began investigating a school cluster of students experiencing tic-like behaviors thought to be related to recent COVID-19. The objective of this report is to describe the investigation, key findings, and public health recommendations.MethodsAffected students and proxies were interviewed with a standardized questionnaire including validated depression and anxiety screens.ResultsEight students had tic-like behaviors lasting >24 h after initial report with onset during September 26–October 30, 2021. All eight students were females aged 15–17 years. All students either had a history of depression or anxiety or scored as having more than minimal anxiety or depression on validated screens. Four students previously had confirmed COVID-19: the interval between prior COVID-19 and tic symptom onset varied from more than a year prior to tic symptom onset to at the time of tic symptom onset.ConclusionThe onset of tic-like behaviors at one school in Minnesota appeared to be related more to underlying mental health conditions than recent COVID-19. These findings highlight the need to better understand functional tic-like behaviors and adolescent mental health.

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