From the Guidelines
Imaging for Worsening Tic
For patients presenting with worsening tics, magnetic resonance imaging (MRI) of the brain is the preferred initial imaging modality to rule out underlying structural abnormalities, such as basal ganglia iron accumulation, which is better detected by MRI than CT 1.
- MRI is the most sensitive imaging modality for detecting abnormalities in the basal ganglia, making it the first-line choice for evaluating worsening tics.
- CT Head may be considered in specific situations where MRI is contraindicated or unavailable, or to distinguish between calcium and iron deposition in the brain 1, but it is not the preferred initial imaging modality due to its limited sensitivity.
- The use of contrast is not typically necessary for initial evaluation 1.
- Other imaging modalities like fluorodeoxyglucose positron emission tomography (FDG-PET) or magnetic resonance angiography (MRA) may be considered on a case-by-case basis for patients with suspected neurodegenerative or inflammatory conditions contributing to tic exacerbation.
From the Research
Imaging for Worsening Tic
- The appropriate imaging for worsening tic is not directly addressed in the provided studies, but some studies discuss the use of imaging modalities in related conditions.
- A study on Tourette's Syndrome 2 mentions the use of functional magnetic resonance imaging (fMRI) to study the neural mechanisms of tics, but does not provide specific guidance on imaging for worsening tic.
- Other studies discuss the use of imaging modalities such as MRI and CT in the diagnosis and management of conditions like mild traumatic brain injury 3, post-concussion syndrome 4, and strabismus 5, but do not address worsening tic specifically.
- A study on magnetic resonance imaging of the brain 6 discusses the optimal screening technique for detection of brain abnormalities, but does not address worsening tic.
- There is no direct evidence to support the use of specific imaging modalities for worsening tic, and the choice of imaging modality would likely depend on the individual clinical presentation and suspected underlying cause of the worsening tic.