CARBAMAZEPINE-INDUCED TICS

A variety of movement disorders are known to occur in association with carbamazepine (CBZ) therapy in adults and children, but development o f tics has been described infrequently and only in patients with under lying Tourette's syndrome or other movement disorders. We report 3 chi ldren with epilepsy who developed facial motor tics after initiation o f CBZ for complex partial seizures. All 3 had documented CBZ blood lev els in the therapeutic range at the time, and none had other symptoms or signs of clinical intoxication. Neurologic examinations were normal in 2 and showed developmental delay of expressive language in the thi rd. Brain imaging was normal in all. After development of the tics in 2, CBZ was continued at the same or higher dose, and the tics abated a nd then ceased spontaneously less-than-or-equal-to 6 months. In the th ird child, the tics ceased after CBZ discontinuation. These cases demo nstrate that CBZ can induce simple motor tics in children. These idios yncratic reactions may be transient and do not always necessitate drug discontinuation.