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862 Tics and the COVID pandemic-observation from a tertiary care seizure clinic

BackgroundThe SARS-CoV-2 pandemic has had a notable negative impact on the overall mental well-being of children and young adults. Those with Tourette syndrome have had worsening of both tics and associated co-morbidity such as obsessive behaviours along with sleep disturbance. Social isolation is likely to have not helped this vulnerable population.ObjectivesThe current study aims to document the impact of COVID 19 on tic exacerbations, frequency, severity and type of tics, incidence of Tourette syndrome and child and parent-perceived change in the pattern of tics among a cohort of children attending seizure clinic.MethodsThis observational study reviewed patient numbers of tics/tic-like functional neurological symptoms in a cohort of children attending a seizure clinic at the department of paediatrics, Oxford University Hospitals NHS Foundation Trust, United Kingdom. The data was reviewed for a one year period (March 2020 to March 2021) and compared to the pre-pandemic numbers over a similar duration. Feedback given by children having tics and their parents were considered in documenting specific observations.ResultsThere was over four-fold increase in the number of children presenting with tics over the observation period compared to the preceding year. Tic-like functional neurological presentations also had increased dramatically (both vocal and motor phenomena) and a small proportion of these children mentioned seeing videos of popular personalities with tics on a social media platform. New diagnosis of Tourette syndrome saw a three-fold increase in this set-up. On the positive side, home schooling had helped some children with pre-existing tics with regards to the perceived severity. These parents reported that their children felt no necessity to suppress their tics all day (unlike whilst in school) and hence they observed a steady pattern of tics rather than significant troublesome outbursts in the evenings. A third had associated sleep disturbance.ConclusionsOurs is an interesting observation and discussions with colleagues in the wider set-up revealed similar patterns. Documenting this will help inform healthcare providers with a view to expanding available mental health expertise for this challenging cohort of children and young adults.