Tic disorder

Introduction

A tic is a problem in which a part of the body moves repeatedly, quickly, suddenly and uncontrollably. Tics can occur in any body part, such as the face, shoulders, hands or legs. They can be stopped voluntarily for brief periods. Sounds that are made involuntarily (such as throat clearing, sniffing) are called vocal tics. Most tics are mild and hardly noticeable. However, in some cases they are frequent and severe, and can affect many areas of a child's life.

Overview and Facts

The most common tic disorder is called "transient tic disorder" and may affect up to 10 percent of children during the early school years. Teachers or others may notice the tics and wonder if the child is under stress or "nervous." Transient tics go away by themselves. Some may get worse with anxiety, fatigue or stress.

Symptoms

Some tics do not go away. Tics which last one year or more are called "chronic tics." Chronic tics affect less than one percent of children and may be related to a special, more unusual tic disorder called Tourette's Disorder.
Children with Tourette's Disorder have both body and vocal tics (such as throat clearing). Vocal and motor tics do not appear at the same time, and may often come and go. Some tics disappear by early adulthood, and some continue. Children with Tourette's Disorder may also have problems with attention, obsessions (OCD), and learning disabilities. They may develop impulsivity or irritability.
Sometimes people with Tourette's Disorder may blurt out obscene words, insult others, or make obscene gestures or movements. They cannot control these sounds and movements and should not be blamed for them. Punishment by parents, teasing by classmates, and scolding by teachers will not help the child to control the tics but will hurt the child's self-esteem and increase their distress. Motor or body tics may become very severe and cause pain in their location (e.g. neck).

Causes and Risk Factors

The exact cause of tics is not known, and there's no known way to prevent it. Tic Disorders is a complex syndrome, likely caused by a combination of genetic and environmental factors. Theories about the causes of Tics include:

Genetics. Tics Disorder may be an inherited disorder. The specific genes involved in Tics Disorder are still being defined, although one genetic mutation has been identified as a rare cause of Tics Disorder.
Brain abnormalities. Certain chemicals in the brain that transmit nerve impulses (neurotransmitters) may play a role, including dopamine and serotonin.

Risk factors for Tics include:

Family history. Having a family history of tic disorders or OCD may increase the risk of developing tics syndrome.
Being male. Males are about three to four times more likely than females to develop tics.

Tests and Diagnosis

There's no specific test that can diagnose tics. Instead, doctors must rely on the history of symptoms to diagnose the disorder.
Diagnosis of tics may be delayed because families and even doctors are sometimes unfamiliar with the symptoms, or the symptoms may mimic other problems. Eye blinking may be initially mistaken for eye or vision problems, for instance, while nose sniffling may be attributed to allergies, colds or sinus problems.
Because other serious health conditions can cause motor or vocal tics, your doctor may suggest having tests to rule out other causes. These tests include blood tests or neuroimaging studies, such as magnetic resonance imaging (MRI).

Treatment

Through a comprehensive evaluation, a child and adolescent psychiatrist can determine whether a youngster has a Tic Disorder. Treatment for the child with a tic disorder may include medication to help control the symptoms and habit reversal training; a behavioral therapy. The child and adolescent psychiatrist can also advise the family about how to provide emotional support and the appropriate educational environment for the youngster.