Skip to main content Accessibility help

Attenuation of Apparent New-Onset Ocular Tics with Successful Treatment of PTSD

  • Patrick C. Hayes, Charles L. Weber, Michael B. Gallagher and Gary J. Drouillard


This case report describes a patient with reportedly new onset of tics, beginning at 21 years of age, in the context of posttraumatic stress disorder (PTSD) and comorbid alcohol abuse, with no known head injury. The setting is an American Society of Addiction Medicine intensive outpatient substance abuse rehabilitation program in an United States Army Medical Center. The patient is a 22-year-old male diagnosed with alcohol abuse and delayed PTSD who presented to the program's medical officer due to insomnia. We discovered he had a reportedly new ocular tic of ∼9 months duration, which he claimed developed at 21 years of age soon after returning from 1 year of combat duty. The patient was thoroughly evaluated, and we surmised the tic was a symptom of PTSD. After achieving full remission from alcohol, the tic persisted. However, as his PTSD symptoms remitted, so did his tic symptoms. At 6-month follow-up, the patient reported he was essentially free from PTSD symptoms, and his tic was significantly reduced.


Corresponding author

Please direct all correspondence to: CPT(P) Patrick C. Hayes, MD,Bayne Jones Army Community Hospital, 1585 Third Street, Fort Polk, LA 71459; Tel: 337-531-3922; E-mail:


Hide All
1.Altindag, A, Yanik, M, Asoglu, M. The emergence of tics during escitalopram and sertraline treatment. Int Clin Psychopharmacol. 2005;20:177178.
2.Diagnostic and Statistical Manual of Mental Disorders. 4th ed, text rev. Washington, DC: American Psychiatric Assiocation; 2000.
3.Bryant, RA, Harvey, AG, Gordon, E, Barry, RJ. Eye movement and electrodermal responses to threat stimuli in post-traumatic stress disorder. Int J Psychophysiol. 1995;20:209213.
4.Buckley, TC, Kaloupek, DG. A meta-analytic examination of basal cardiovascular activity in posttraumatic stress disorder. Psychosom Med. 2001;63:585594.
5.Cerbone, A, Sautter, FJ, Manguno-Mire, G, et al.Differences in smooth pursuit eye movement between posttraumatic stress disorder with secondary psychotic symptoms and schizophrenia. Schizophr Res. 2003;63:5962.
6.Cohen, ML, Quintner, JL. The derailment of railway spine: a timely lesson for posttraumatic fibromyalgia syndrome. Pain Reviews. 1996;3:181202.
7.Combs, DE. EMDR Controversial. Available at: Accessed May 3, 2006.
8.Cunningham, M, Cunningham, K, Lydiard, RB. Eye tics and subjective hearing impairment during fluoxetine therapy. Am J Psychiatry. 1990;147:947948.
9.Ewing, JA. Detecting alcoholism. The CAGE questionnaire. JAMA. 1984;252:19051907.
10.Factor, SA, Molho, ES. Adult-onset tics associated with peripheral injury. Mov Disord. 1997;12:10521055.
11.Fennig, S, Fennig, SN, Pato, M, Weitzman, A. Emergence of symptoms of Tourette's syndrome during fluvoxamine treatment of obsessive-compulsive disorder. Br J Psychiatry. 1994;164:839841.
12.Frasier, F, Wilson, RM. The sympathetic nervous system and the “irritable heart of soldiers.” BMJ. 1918;13:2729.
13.Friedman, EH. The neurobiology of posttraumatic stress disorder (PTSD). Biol Psychiatry. 1994;35:500.
14.Gaul, JJ. Posttraumatic tic disorder. Mov Disord. 1994;9:121.
15.Grillon, C, Morgan, CA 3rd. Fear-potentiated startle conditioning to explicit and contextual cues in Gulf War veterans with posttraumatic stress disorder. J Abnorm Psychol. 1999;108:134142.
16.Hassard, A. Reverse learning and the physiological basis of eye movement desensitization. Med Hypotheses. 1996;47:277282.
17.Hauser, RA. Zesiewicz, TA. Sertraline-induced exacerbation of tics in Tourette's syndrome. Mov Disord. 1995;10:682684.
18.Kingsbury, A. The life and death of a soldier/one soldier's story. U.S. News and World Report. May 21, 2007. Volume 142, number 18. Pages 3945.
19.Kumar, A, Balan, S. Fluoxetine for persistent developmental stuttering. Clin Neuropharmacol. 2007;30:5859.
20.Kumar, R. Lang AE. Tourette syndrome. Secondary tic disorders. Neurol Clin. 1997;15:309331.
21.Lenti, C. Movement disorders associated with fluvoxamine. J Am Acad Child Adolesc Psychiatry. 1999;38:942943.
22.McFarlane, AC, Weber, DL, Clark, CR. Abnormal stimulus processing in posttraumatic stress disorder. Biol Psychiatry. 1993;34:311320.
23.Meakins, JC, Wilson, RM. The effect of certain sensory stimulations on respiratory and heart rate in cases of so-called. “irritable heart”. Heart. 1918;7:1722.
24.Orr, SP, Metzger, LJ, Pitman, RK. Psychophysiology of post-traumatic stress disorder. Psychiatr Clin North Am. 2002;25:271293.
25.Pitman, RK, Orr, SP, Shalev, AY, Metzger, LJ, Mellman, TA. Psychophysiological alterations in post-traumatic stress disorder. Semin Clin Neuropsychiatry. 1999;4:234241.
26.Ranjan, S, Sawhney, V, Chandra, PS. Persistent developmental stuttering: treatment with risperidone. Aust N Z J Psychiatry. 2006;40:193.
27.Ross, RJ, Ball, WA, Dinges, DF, et al.Motor dysfunction during sleep in posttraumatic stress disorder. Sleep. 1994;17:723732.
28.Rüth, U, Mayer-Rosa, J, Schlamp, D, Freisleder, FJ. Tourette's syndrome and antidepressant therapy: exacerbation of nervous tics with paroxetine [German]. Z Kinder Jugendpsychiatr Psychother. 2000;28:105108.
29.Siemers, E, Pascuzzi, R. Posttraumatic tic disorder. Mov Disord. 1990;5:183.
30.Singer, C, Sanchez-Ramos, J, Weiner, WJ. A case of post-traumatic tic disorder. Mov Disord. 1989;4:342344.
31.Stickgold, R. EMDR: a putative neurobiological mechanism of action. J Clin Psychol. 2002;58:6175.
32.Vasterling, JJ, Proctor, SP, Amoroso, P, Kane, R, Heeren, T, White, RF. Neuropsychological outcomes of army personnel following deployment to the Iraq war. JAMA. 2006;296:519530.

Attenuation of Apparent New-Onset Ocular Tics with Successful Treatment of PTSD

  • Patrick C. Hayes, Charles L. Weber, Michael B. Gallagher and Gary J. Drouillard


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed