Good morning
D.E:
If you
haven't found it already you may be interested in reading a paper I
wrote about the possible links between TS symptoms and strep throat
-- the paper is called "Syndenham's Tourettic PANDAS" and
can be found at www.lifesatwitch.com/research.html.
However, any associations made between tics and infections tend to suggest
that treatments that render that infection immune help rather than exacerbate
tics. I did a medical database search and could not find any published
papers, reports, or letters that have found any relationship between
immunizations and tics.
I wrote
the above response assuming that the vocal tic you spoke of was the
ONLY tic that your daughter had ever had, which re-occurred following
her immunization. Even if you were saying that your daughter has other
tics and THIS PARTICULAR TIC re-occurred following the immunization,
there is no evidence to suggest that certain triggers will lead to specific
tics. Furthermore, with my knowledge of the neurology of TS I cannot
even think of a rationale for why or how that might occur.
I wasn't
aware that someone could be totally tic-free for a year and then have
the tic re-occur.
This is
absolutely possible -- for example I have a snorting tic right now that
I have not had since 2nd year university (7 years ago). In a more global
sense as well tics can decrease and increase again as a result of changed
environment, growth, time of day, medications, etc.......... the timing
of immunization and waxing of a tic could be entirely coincidental (in
other words, seeing a re-occurance of a tic that causes distress to
you could lead you to link this event with ANY other salient event that
has just occurred in your daughter's life).
TS first
begins to present around the ages of 5 to 7-- in the age range you say
your daughter has been over the past year. While it might be more unusual
for a person in their teens to have a sudden loss of all tics for a
year, and then have them re-occur, manifesting such a pattern at your
daughter's age is less surprising. Your daughter may be "working
toward" an eventual diagnosis of TS, or she may simply be experiencing
some transient tics as she develops (certainly on the TS spectrum, but
"sub-clinical" -- below a diagnosable level of symptoms).
Time will tell.
Finally,
given that the immunization and the re-occurance of this tic were over
20 days apart from one another leads me to even reject the idea that
the general physical and mental stress of an immunization may have indirectly
led to a tic increase.
I am
very distressed and feel extremely guilty about this.
Even if
there were substantial evidence that irrevocably proved that
immunizations always increase tics (which there most certainly is not!)
I would plead with you to not feel guilty. The decisions a person makes
in the absence of certain knowledge is not IN THE SLIGHTEST a reflection
of who that person is, or how they feel. You said that you agonized
over the decision to immunize or not -- that in itself tells me that
you a.) were thinking, b.) care tremendously about the well-being of
your daughter, and c.) wanted to do what was right. I see nothing worthy
of regret in that.
Have an
excellent day, D.E. It sounds like you deserve to allow yourself
one.
Dr. Dunc.
