Tic disorders are a type of repetitive behavioral disorder. A tic is an irregular, uncontrollable, unwanted, and repetitive movement of muscles occurring anywhere in the body.
The movement of limbs and other body parts is called motor tic. It is called vocal tics when repetitions of sounds, such as grunting, sniffing, or throat clearing, occur involuntarily.
It is common for tic disorders to start in childhood, usually at the age of 5 or 6. These disorders are more common in males than in females.
It is common for tics to be temporary, resolving within a year. Tics can also become chronic. Approximately 1 in 100 people suffer from chronic tics.
Read: Facial Tics Disorder
Types of tic disorders
The three types of tic disorders are motor, vocal, or Tourette’s syndrome, which is a combination of motor and vocal disorders.
It is possible for vocal and motor tics to be short-lived (transient) or chronic. Among chronic tic disorders is Tourette’s syndrome.
Transient tic disorder
An estimated ten percent of children during their early school years have transient tic disorder or provisional tic disorder, according to the American Academy of Child and Adolescent Psychiatry.
Tic disorders usually last less than 12 consecutive months and involve at least one tic. It must have started before the age of 18 that the individual began experiencing tics.
When a person has transient tic disorder, motor tics are more common than vocal tics. There can be changes in the severity and type of tics throughout the course.
Children with learning disabilities and students in special education appear to be more prone to tics, according to some research. Autistic kids have also been found to be more prone to tics.
Read: Motor Disorders
Chronic motor or vocal tic disorder
It is classified as chronic tic disorder if the tic appears before the age of 18 and lasts for more than one year. It can present as motor or vocal tics, but not both.
Chronic tic disorder affects fewer than one percent of children, compared to transient tic disorder.
The likelihood that a child will recover from a chronic motor or vocal tic disorder is greater if they are younger at the time of onset. Tics usually disappear within six years after onset. Symptoms are less likely to resolve for people who experience them past the age of 18.
Tourette’s syndrome (TS) is a complex neurological disorder. There are both motor and vocal tics associated with the disorder. However, it is not the most common of tic disorders.
There is no exact figure for the number of people with TS, according to the Centers for Disease Control and Prevention. Children with the condition are not diagnosed in half of the cases, according to research conducted by the CDC. The US is currently suffering from a 0.3 percent TS prevalence rate among children aged 6 to 17.
The severity of TS symptoms varies over time. The condition may improve with age for some people.
In addition to TS, other conditions, such as attention deficit hyperactivity disorder (ADHD) and obsession with things (OCD), may also be present.
Read: Stereotypic Movement Disorder
Tic disorders symptoms
One or more tics are a defining symptom of tic disorders. There are four types of tics:
- Motor tics: There are several types of tics, including head and shoulder movements, blinking, jerking, banging, clicking fingers, and touching objects or people. Although this is not always the case, motor tic tends to appear before vocal tic.
- Vocal tics: Coughing, clearing the throat, grunting, or repeating words or phrases are examples of these sounds.
They can also be classified as follows:
- Simple tics: This type of tic uses few muscle groups and occurs suddenly and briefly. A clear throat indicates twitching of the nose or eye darting.
- Complex tics: Tics involving coordinated muscle movements. These actions often consist of hopping, stepping, gesturing, or repeating words or phrases.
The onset of a tic is usually preceded by a tingling or itching sensation. The act of resisting a tic can be done, but it often involves a great deal of effort and causes stress. When the tic is carried out, these sensations are relieved.
The symptoms of tic disorders include:
- It becomes worse when you are experiencing emotions like anxiety, excitement, anger or fatigue
- Also worsened by illness
- Also worsened by extreme temperatures
- Occurs while sleeping
- Changes over time
- Vary in severity and type
- Get better over time
Read: Generalized Dystonia
Risk factors and causes
Tic disorders are not known to have an exact cause. Several gene mutations have been identified recently that may play a role in Tourette’s. Several brain chemicals, including glutamate, serotonin, and dopamine, seem to play a role in dementia.
Disorders with a direct cause are classified as different kinds of diagnoses. Tics caused by:
- Head injuries
- Other injuries
Tics can also be caused by other, more serious medical conditions such as Huntington’s disease or Creutzfeldt-Jakob disease.
Tic disorders are associated with:
- Genetics: Genetic factors may contribute to the development of these disorders since tics often run in families.
- Sex: People with tic disorders are more likely to be male.
Read: Focal Dystonia
Tic disorders are particularly common among young children with TS:
- Autism spectrum disorder
- Learning difficulties
- Speech and language difficulties
- Sleep difficulties
Tic disorders may also cause problems with self-esteem and self-image in addition to physical symptoms.
Children with tic disorders, especially TS, tend to have lower self-esteem and a poorer quality of life than children without such disorders.
TS and associated conditions, including ADHD and anxiety, have been linked to decreased social functioning in people with the disorder, according to the Tourette Association of America.
There are signs and symptoms associated with tic disorders. Symptoms of tic disorder must appear when the child is under 18 years of age. They should also be unrelated to any other medical condition or medication.
One or more tic behaviors occurring less than 12 months in a row are considered signs of transient tic disorder.
One or more tics occur almost daily for 12 months or more to be diagnosed as chronic motor or vocal tic disorders. There are many chronic tic disorders that are not TS, and the affected people will experience either motor tics or vocal tics, but not both.
Tics are present almost every day for at least a year, as well as motor and vocal tics. Usually, cases are diagnosed in children under 11 years old. Behavioral problems are also common.
If your child exhibits tics, you may have your doctor rule out other causes like:
- Blood tests
- MRI scans or other imaging
Treatment for tic disorders
There are different types of tic disorders, and the severity of the disorder will determine how to treat it. Sometimes tic disorders won’t require treatment.
Therapy, medications, and deep brain stimulation are effective ways to deal with severe tics.
Therapies for tic disorders
Tics can be controlled and reduced with certain therapies, including:
- Exposure and response prevention (ERP): An approach that aims to get people used to the unpleasant urges that precede tic-like behaviors, with the goal of preventing tic occurrences.
- Habit reversal therapy: It is a method for teaching people with tic disorders how to overcome their tics by using movements as competition.
Medication for tic disorders
Medications can be used alone or in conjunction with therapy. Although medications can reduce tic frequency, they do not completely eliminate the symptoms. Among the most common medications are:
- Anti-seizure medications
- Botox injections
- Muscle relaxants
- Dopamine-interacting medications
Tic disorders may also be treated with other medications. It is possible to prescribe antidepressants to treat anxiety and OCD symptoms.
Deep brain stimulation
TS patients whose tics cannot be controlled with other treatments and are limiting their quality of life have the option of deep brain stimulation (DBS).
Brain implants, such as DBS, involve the implant of a battery-operated device. Electrical stimulation is used to reduce tics by stimulating areas of the brain that control movement.
Coping and self-help tips
Changing your lifestyle can be helpful in reducing tic frequency. These include:
- Reducing stress and anxiety
- Maintaining a healthy sleep pattern
Helpful tips include:
- Find a TS or other tic disorder support group
- Get support from friends and family
- Keep in mind that tics typically improve with age
If your child has tics, you should:
Keep an eye on the child when a tic occurs, but don’t point it out.
- Inform the teacher, caregiver, and anyone who knows the child about his/her condition
- Encourage the child’s interests and friendships to boost self-esteem