Child Neurology: Simple Motor Tics Associated With Thalamic Ganglioglioma

Tic disorders (TDs) include a heterogeneous group of neurodevelopmental conditions linked to dysfunction of the cortical-striatal-thalamic-cortical (CSTC) circuit. In this article, we report a case of a 9-year-old boy who presented with infrequent tics affecting the right eye and mouth. Brain imaging revealed a T2-weighted hyperintense mass in the left thalamus. His tic symptoms resolved completely after lesionectomy. Neuropathology analysis showed dysplastic neurons, reactive gliosis, microvascular hyperplasia, and chronic inflammatory cell infiltration suggestive of ganglioglioma. Review of the literature identified 6 cases linking TDs to brain tumors, all of which involved multiple components of the CSTC circuit. TDs in these cases manifested as a combination of multiple motor and vocal tics, often with comorbidities such as obsessive-compulsive disorder and attention-deficit hyperactivity disorder. By contrast, our case presented solely with simple motor tics, which resolved after lesionectomy. The exclusive thalamic involvement in this case supports the critical role of the thalamus in the etiopathogenesis of TD. This case provides valuable insights into the structural basis of the clinical manifestations in patients with TD.