Tic Disorders

What are Tic Disorders

Tic disorders refers to a condition in which a person makes sudden and repeated movements or sounds (tics). There are three types of tic disorders:

  • Transient or provisional tic disorder (common). This type usually goes away within a year or two.
  • Chronic or persistent tic disorder. This type may last all through childhood and continue into the adult years.
  • Tourette syndrome (rare). This type lasts through all of life. It often occurs with other disorders.

Tic disorders starts before age 18, usually between age of 5 and 10. These disorders cannot be cured, but there are many treatments that can help manage tics. Most tic disorders get better over time.

What are the causes?

The cause of this condition is not known.

What are the signs or symptoms?

The main symptom of this condition is experiencing tics. There are four type of tics:

  • Simple motor tics. These are movements in one area of the body.
  • Complex motor tics. These are movements in large areas or in several areas of the body.
  • Simple vocal tics. These are single sounds.
  • Complex vocal tics. These are sounds that include several words or phrases.

Tics range in severity and may be more severe when you are stressed or tired. Tics can change over time.

Symptoms of simple motor tics

  • Blinking, squinting, or eyebrow raising.
  • Nose wrinkling.
  • Mouth twitching, grimacing, or making tongue movements.
  • Head nodding or twisting.
  • Shoulder shrugging.
  • Arm jerking.
  • Foot shaking.

Symptoms of complex motor tics

  • Grooming behavior, such as combing one’s hair.
  • Smelling objects.
  • Jumping.
  • Imitating others’ behavior.
  • Making rude or obscene gestures.

Symptoms of simple vocal tics

  • Coughing.
  • Humming.
  • Throat clearing.
  • Grunting.
  • Yawning.
  • Sniffing.
  • Barking.
  • Snorting.

Symptoms of complex vocal tics

  • Imitating what others say.
  • Saying words and sentences that may:
    • Seem out of context.
    • Be rude.

How is this diagnosed?

This condition is diagnosed based on:

  • Your symptoms.
  • Your medical history.
  • A physical exam.
  • An exam of your nervous system (neurological exam).
  • Tests. These may be done to rule out other conditions that cause symptoms like tics. Tests may include:
    • Blood tests.
    • Brain imaging tests.

Your health care provider will ask you about:

  • The type of tics you have.
  • When the tics started and how often they happen.
  • How the tics affect your daily activities.
  • Other medical issues you may have.
  • Whether you take over-the-counter or prescription medicines.
  • Whether you use any drugs.

You may be referred to a brain and nerve specialist (neurologist) or a mental health specialist for further evaluation.

How is this treated?

Treatment for this condition depends on how severe your tics are. If they are mild, you may not need treatment. If they are more severe, you may benefit from treatment. Some treatments include:

  • Cognitive behavioral therapy. This kind of therapy involves talking to a mental health professional. The therapist can help you to:
    • Become more aware of your tics.
    • Learn ways to control your tics.
    • Know how to disguise your tics.
  • Family therapy. This kind of therapy provides education and emotional support for your family members.
  • Medicine that helps to control tics.
  • Medicine that is injected into the body to relax muscles (botulinum toxin). This may be a treatment option if your tics are severe.
  • Electrical stimulation of the brain (deep brain stimulation). This may be a treatment option if your tics are severe.

Follow these instructions at home:

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Check with your health care provider before using any new prescription or over-the-counter medicines.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You are not able to take your medicines as prescribed.
  • Your symptoms get worse.
  • Your symptoms are interfering with your ability to function normally at home, work, or school.
  • You have new or unusual symptoms like pain or weakness.
  • Your symptoms make you feel depressed or anxious.

Summary

  • A tic disorder is a condition in which a person makes sudden and repeated movements or sounds.
  • Tic disorders start before age 18, usually between the age of 5 and 10.
  • Many tic disorders are mild and do not need treatment.
  • These disorders cannot be cured, but there are many treatments that can help manage tics.
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