Intriguing Remission of Tourette’s After Heat-Induced Dehydration
A young man with a diagnosis of Tourette syndrome had experienced tics since age 7. He had a marked reduction in tics for almost two years after undergoing dehydration by entering a hot tub for 3 to 4 hours in his early 20’s. Lead researcher, Dr. James Brašić at Johns Hopkins University, provided the latest version of an open-access journal report on this case, linked at the bottom of this page. (Note: The photo used in our article is a stock image and does not intend to reflect the type of hot tub used.)
As a young boy, this person experienced motor tics including eye blinking, grimacing, and movements of head, shoulders, and fingers, and phonic tics, including grunting, snorting, and sniffing. Tics were exacerbated by cold, fatigue, and anxiety.
He began to display multiple tics simultaneously such as turning his head to his shoulder along with a shoulder shrug. Starting at age 10, he began to experience vomiting that only occurred on occasion when he’d had a few bites of food or was halfway through a meal. He was unable to carry packages with bottles out of fear that tics would cause him to drop them. At age 22 he had trials of clonidine and topiramate, but they had minimal effect on the tics.
This fellow has a family history of Tourette syndrome. After the episode of heat and dehydration at age 24, he was basically tic-free for 18 months until he had a tetanus immunization. With that, his tics increased severely for two weeks. He has since been able to maintain without conventional medications. At age 29 he began taking THC (Δ9-tetrahydrocannabinol) as an inhaled vaper and has experienced only mild tics for years; he is now 32.
Although it is a single case study with questions remaining, the authors suggest “Prospective testing of the heat and dehydration effect on tics should be pursued.”
The article notes that while some people with Tourette syndrome find tics improve with heat, others have reported worsening of tics with heat. ACN Latitudes.org is not recommending that people pursue this approach without medical advice and supervision.
Study Abstract
Heat has been reported to exert variable effects on people with Gilles de la Tourette syndrome (TS). At 24 years of age, a 32-year-old right-handed man with TS experienced a marked reduction in tics for two years after undergoing dehydration by entering a hot tub at 103°F (39.4°C) to 104°F (40.0°C) for 3 to 4 hours.
On the Yale Global Tic Severity Scale (YGTSS) he scored 55 seven months before dehydration and 13 one month after dehydration. An intense heat exposure and dehydration led to an apparent remission in tics. The remission continued without the use of prescribed or nonprescribed medications or substances for two years until tics returned in the worst ever exacerbation after a tetanus immunization.
The heat exposure may have altered at least temporarily his thermostat for normal heat-loss mechanisms through dopaminergic pathways from the anterior hypothalamus to the basal ganglia and the substantia nigra. Whether or not that mechanism or some other mechanism relevant to the heat exposure and/or dehydration is at play, the sudden and marked improvement in his tics needs further attention. Prospective testing of the heat and dehydration effect on tics should be pursued.
See the full article (PDF) Brasic Remission nihms-982518
