Transcutaneous Vagal Nerve Stimulation & Breathing Exercises Reduce Motor and Vocal Tics in Eleven-Year-Old Male
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1
Carrick Institute, United States
Background:
An eleven-year-old male presented with chief complaint of persistent daily motor and vocal tics. Tics had an abrupt onset and are stress provoked. No medications. Supplements included fish oil.
Methods:
Neurological examination revealed motor and vocal tics, startle response with 512 K tuning fork, right pupil miosis, increased error rate with anti-saccades, leftward sway with Romberg's, left dysdiadokokinesia, hypotonia noted in bilateral upper extremities, decreased bilateral arm swing with gait, truncal ataxia and left lateropulsion noted with dual tasking of gait.
Real-time heart rate variability assessment showed a marked decrease in LF/HF ratio with transcutaneous vagal nerve stimulation (tVNS) performed at the left cymba concha and the palmar surface of the left wrist, pulse rate 2 Hertz, pulse width 300, and intensity 2-3 mA (strong but not unpleasant) with fatigue noted after three minutes of stimulation.
tVNS was performed as described above for 2 mins, two times daily at home. The patient was also given breathing exercises to be performed for 5 mins per day at 5.5 respirations per minute.
Results:
After 30 days no motor or vocal tics were reported 6 of 7 days of the week. Gait showed normal arm swing and significantly reduced truncal ataxia and left lateropulsion.
Conclusion:
tVNS and breathing exercises might be helpful in the management of motor and vocal tics. Further investigation into tVNS and breathing exercises in the treatment of patients with motor and vocal tics is suggested.
Keywords:
Transcutaneous vagus nerve stimulation,
Breathing Exercises,
non-invasive brain stimulation,
Relaxation Therapy,
tics and tourette syndrome
Conference:
International Symposium on Clinical Neuroscience 2018, Orlando, Florida, United States, 24 May - 26 May, 2018.
Presentation Type:
Poster
Topic:
Clinical Applications in health, disease, and injury to the nervous system
Citation:
Caffery
C
(2018). Transcutaneous Vagal Nerve Stimulation & Breathing Exercises Reduce Motor and Vocal Tics in Eleven-Year-Old Male.
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience 2018.
doi: 10.3389/conf.fneur.2018.60.00081
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Received:
31 Mar 2018;
Published Online:
14 Dec 2018.
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Correspondence:
Dr. Chris Caffery, Carrick Institute, Cape Canaveral, United States, drcaffery@gmail.com