What is a tic?
Tics are brief, sudden movements or sounds. They may happen at random or irregular times. They may happen many times each day. A tic is hard to stop consciously, but you are awake and aware at all times during a tic. Tics do not cause you to lose consciousness.
There are two types of tics: motor tics and vocal tics. Motor tics involve movement of some part of your body. Vocal tics involve making some kind of sound with your mouth or vocal cords. Both kinds of tics can be either simple or complex.
• Simple motor tics involve a single group of muscles, such as the eyelid.
• Complex motor tics involve more than one group of muscles, such as the
eyelid, cheek, and neck.
• Simple motor tics are rapid motions. complex motor tics are slower and
seem to be almost purposeful.
• Simple vocal tics involve sounds which are not words and do not mean
• Complex vocal tics involve speaking words out loud.
Examples of motor tics include:
• nose wrinkling
• shoulder shrugging
• eye blinking
• facial grimacing
• repetitive or obsessive touching
• head twitching
Examples of vocal tics include:
• throat clearing
• repetitive (unintentional) swearing
Are the Tics Transient or Chronic?
Most people with tics have transient tics, which means that the tics last for a few days to months and then never come back. Tics that last for more than a year are called chronic tics. People with chronic tics have what is called chronic tic disorder. Chronic tics can be either motor or vocal and can change over time. For example, you can have a motor tic such as head twitches for a number of weeks, and then they go away. Then you might have
a new motor tic like eye blinking or facial grimacing.
What is Tourette Syndrome?
Tourette Syndrome is when you have both vocal and motor tics for more than a yearIt can be mild or severe, and is treated the same way as other chronic tic disorders.
What can make tics worse?
• Feeling embarrassed about having tics.
• Feeling nervous about something like standing up and making a speech.
• Feeling tired or stressed. For example staying up late to finish homework or a project for the next day.
• Getting sick. For some people, even a mild illness like a cold can make tics worse. Antibiotics can help you fight off a bacterial illness. They will not help a viral illness and will not stop tics once they start. See or call your doctor for advice if you think you have a bacterial illness.
How are tics diagnosed?
Tics are often straightforward to diagnose at a doctor’s visit. Your doctor might want to have some lab testing done to rule out other conditions that may look like tics but are not. These tests may involve checking a blood or sometimes urine sample. You do not need to do a brain scan (MRI or CAT scan) if you have transient or chronic tics.
Are tics bad for me?
No, tics do not damage your brain. They do not make you any less smart. Some people with tics have pain if the tic involves a violent motion, such as flinging your head to one side, or biting down on your own tongue or cheek. More often, tics can be a source of embarrassment, especially if you are a preteen or teenager. It is wrong to make fun of people with tics. It is wrong for people to make fun of you if you have tics. If people do make fun of you, you can tell them that you do not have control over your movements. Most teachers are willing and happy to teach your peers about this.
Will my tics go away?
Many children who have chronic tics do outgrow them. About half of children with chronic tic disorder outgrow tics by early adulthood, and most of those who still have tics will notice a decrease in the severity of the tics.
Treating tics with medicines (see below) does not make the tics go away any faster. It does not improve your chances of outgrowing them. Medicines only stop the tics for awhile.
Are there other conditions that come with tics?
Some children with tics will have problems with attention and hyperactivity. This is called attention deficit hyperactivity disorder, or ADHD. Others may have problems like excessive hand washing, compulsive touching, or repeated checking of doors or lights. This is called obsessive compulsive disorder, or OCD. Anxiety disorder is also common. For some children, these symptoms can be very upsetting and may need to be addressed by a psychologist or psychiatrist.
What is PANDAS?
PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. The theory of PANDAS is that strep infections like strep throat can trigger an worsening of tics or of symptoms of ADHD, OCD or anxiety (see paragraph above). Doctors do not agree on whether this PANDAS really exists or what to do about it. Many doctors do not believe it really exists. Other doctors think that any kind of infection, not just a strep infection, can also trigger or worsen tics in susceptible children. All doctors agree that most children with tics do not have PANDAS and many children with tics do not have more tics with infectious illnesses. Talk to your doctor if you have questions about this.
Here are some tips to help with tics:
• Don’t focus on the tic. Thinking about it makes it worse.
• Avoid stress when you can. Give yourself plenty of time to get projects done
so that you don’t make your tics worse by waiting until the last minute.
• Be sure to get enough rest. Not getting enough sleep can make tics worse.
• If you feel a tic coming on, let it go. Don’t hold back. If you try to hold it
back, it will be much worse.
• Don’t point out other people’s tics. If you do, it will embarrass them and
make it worse.
Your doctor or neurologist can prescribe medicine for you if the tics are painful or really embarrass you. Ask about potential side effects of each medicine to find the one that fits you best. Medicines may not make the tics go away completely. If your goal is that the tics go away enough to make you feel more comfortable, taking medicines may be a good plan for you.
Behavioral Psychology may help reverse the behaviors of tics by teaching you:
• To recognize when you are about to have a tic
• How to train yourself not to go through with the tic.
This kind of treatment can work as well as medicines but is hard and you need to practice a lot. Ask to see a behavioral psychologist if you would like to try this treatment.
Deep Brain Stimulation is a treatment for very severe tics which do not respond to any other treatment. It is a surgery to implant an electrode deep in the brain. You need to have an extensive medical workup to decide if it is necessary and would be helpful for you.
Some reputable websites you can check out include:
• Tourette Syndrome Association: http://www.tsa-usa.org/
• Worldwide Education and Awareness for Movement Disorders (WE MOVE):
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 10/09/2012
Copyright © 10/09/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7435
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