{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:33:01Z","timestamp":1791484381028,"version":"4.3.4"},"reference-count":46,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2007,6,12]],"date-time":"2007-06-12T00:00:00Z","timestamp":1181606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2007,9,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of this work was to draw attention to potentially life\u2010threatening symptoms associated with Tourette syndrome (TS) and to explore their relationship to TS comorbidities. Medical records of all patients with TS evaluated at our Movement Disorders Clinic between July 2003 and July 2006 were reviewed. Data on patients with malignant TS, defined as \u22652 emergency room (ER) visits or \u22651 hospitalizations for TS symptoms or its associated behavioral comorbidities, were entered into a dataset and analyzed. Five illustrative cases are described. Of 333 TS patients evaluated during the 3\u2010year period, 17 (5.1%) met the criteria for malignant TS. Hospital admission or ER visits were for tic\u2010related injuries, self\u2010injurious behavior (SIB), uncontrollable violence and temper, and suicidal ideation\/attempts. Compared with patients with nonmalignant TS, those with malignant TS were significantly more likely to have a personal history of obsessive compulsive behavior\/disorder (OCB\/OCD), complex phonic tics, coprolalia, copropraxia, SIB, mood disorder, suicidal ideation, and poor response to medications. Although TS is rarely a disabling disorder, about 5% of patients referred to a specialty clinic have life\u2010threatening symptoms. Malignant TS is associated with greater severity of motor symptoms and the presence of \u22652 behavioral comorbidities. OCD\/OCB in particular may play a central role in malignant TS; obsessive compulsive qualities were associated with life\u2010threatening tics, SIB, and suicidal ideation. Malignant TS is more refractory to medical treatment than nonmalignant TS. \u00a9 2007 Movement Disorder Society<\/jats:p>","DOI":"10.1002\/mds.21599","type":"journal-article","created":{"date-parts":[[2007,6,12]],"date-time":"2007-06-12T18:16:53Z","timestamp":1181672213000},"page":"1743-1750","source":"Crossref","is-referenced-by-count":174,"title":["Malignant Tourette syndrome"],"prefix":"10.1002","volume":"22","author":[{"given":"Min\u2010Yuen 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