Motor tics are part of Tourette syndrome (TS), which usually develops at childhood. Tic disorders are rarely described in adults.

To report a case of isolated, spontaneous adult-onset motor tics treated successfully with pimozide.

To stress the importance of careful assessment of abnormal movements developed at adulthood.

A sixty-four year old lady presented with a 13-month history of abnormal trunk movements preceded by a feeling of tightness in her shoulders. She had repetitive flexor jerks of the trunk, was able to partially suppress it with a sense of rising inner tension. She presented long-term symptoms of anxiety. There was no family or personal history of psychiatric illness or tics. She had never received any neuroleptic. There were no significant findings on physical, neurological, and mental state examination apart from anxiety and tics. Laboratory, electrophysiological, and brain imaging investigations were within normal limits. with a suspected diagnosis of psychogenic myoclonus, she was taking bromazepam 18 mg daily. She had improved her anxiety symptoms, but the jerks kept worsening and she felt sedated. She was started on pimozide 1.0 mg daily.

Notwithstanding the atypical presentation, it is a case of new onset adult tic disorder. She became virtually free of abnormal movements during the eight-week follow-up.

Tic disorders newly presenting during adulthood have occasionally been described, mostly in relation to another neurological or psychiatric disease. There are few descriptions of idiopathic adult onset tics. Treatment attempts are generally not successful, but this patient improved with pimozide.