A case of vocal tic: an unusual presentation of neurobrucellosis.

Brucellosis is the most widespread zoonosis in the world. The disease is endemic in countries bordering the Mediterranean [1–3]. It is a multisystem disease that may present with a broad spectrum of clinical manifestations and complications. Neurologic manifestations of brucellosis are rare, occurring in 3%–5% of patients with systemic brucellosis [4]. Nervous system manifestations are very heterogeneous, and include clinical syndromes like meningitis, encephalitis, myelitis, radiculitis and the involvement of cranial or peripheral nerves [2,5]. In this report we describe a case which presented with unexplained chronic cough, refusal to eat and constipation. The observation of “dry cough with a bark-like vocalizations” and psychiatric consultation established the diagnosis of tic disorder. After the diagnosis and treatment of neurobrucellosis as an underlying condition, vocal tic of the patient completely resolved.