Botulinum Toxin for the Treatment of Motor and Phonic Tics: A Case Report

Objective: To present a unique approach to the treatment of motor and phonic tics. Patient: A 26-year-old male presented with motor and phonic tics including grunting, coughing, and throat clearing. Intervention: The patient was treated with 2.5 units of onabotulinum toxin A (BoNT) to the facial mimetic musculature and 2.5 units to each supraglottic musculature via a transthyrohyoid membrane approach under fiberoptic visualization. Results: The patient experienced reduction in the frequency, intensity, and interference with daily life of motor and phonic tics on the Yale Global Tic Severity Scale (YGTSS). Conclusion: This patient experienced subjective and objective decreases in tic severity using a unique approach in the treatment of phonic tics. Results suggest a novel approach in the treatment of phonic tics and bolster the data regarding safe and effective use of BoNT for tic disorder.