Tics status: a movement disorder emergency

We describe a case of an 18-years-old boy with GTS, who developed severe, continuous, disabling tics after an arbitrary and abrupt withdrawal of haloperidol, tiapride and clonazepam therapy. This exacerbation considered as tics status lasted for weeks despite of intravenous re-administration of these drugs and interfered with sleeping; therefore, propofol and midazolam sedation, and later relaxation with artificial ventilation were applied for an immediate relief. Changing the medication to olanzapine and levetiracetam in parallel to sedation was effective to improve the motor symptoms to the baseline level. As far as the authors are aware, our case is the first published tics status case lasting for weeks and requiring sedation, intubation, and relaxation.