Tourettism secondary to multiple sclerosis

Case presentation: Previously healthy adolescent, started at age 15 with limitation of abduction of the right eye, with spontaneous improvement after two months. A brain magnetic resonance imaging was performed, which showed multiple supratentorial and infratentorial demyelinating lesions, without gadolinium enhancement, and prednisone 60 mg/day was started. After 6 months, she was admitted to the service, due to suppressable involuntary cervical hyperkinetic movements, with an increase in frequency for 3 days. Neurological examination showed hemiparesis predominantly crural, with suppressable tics in the neck, simple vocal tics, incomplete hemihypoesthesia on the right and horizontal diplopia on the right. A pulse with methylprednisolone 1 g/day was performed for 5 days, with no improvement in the tics.