In tics, people can experience unwanted, irregular, repetitive, and uncontrollable movements of muscles in any organ of the body. This problem generally begins in childhood. Tic disorders are more prone in male than female. Most of the cases of tics resolve within a year. Some people can experience persistent tic disorders. Though, cases of persistent tic disorders are a few. Movements of arm, leg, and other organs of the body are called as motor tics. Repetitive involuntary sounds include throat clearing, sniffing, or grunting, are known as vocal tics. Tics can be categorised as vocal, motor, or Tourette's syndrome. Tourette's syndrome is the combination of both vocal and motor tics. Vocal and motor tics can be transient or persistent. Tourette's syndrome is considered to be a persistent or chronic disorder.
People with tic disorders can have one or more tics. Tics can be categorised as:
Vocal tics: Vocal tics include sounds such as grunting or throat clearing, repeating words or coughing.
Motor tics: Motor tics include movement of limbs and other organs of the body such as jerking, clicking fingers, banging, blinking, touching things or touching other people. Generally, motor tics appear before vocal tics but the case can be different.
Simple tics: These tics are sudden and transient using few groups of muscles such as throat clearing, eye darting, or nose twitching.
Complex tics: Coordinated movements are involved in complex tics in which several groups of muscles are used such as stepping or hopping in a certain way, repeating phrases or words, or gesturing.
Generally, tics are preceded by itching or tingling. The symptoms or signs of tics may:
- Get worse due to anger, anxiety, fatigue, and excitement.
- Get worse during illness.
- Appear during sleep.
- Vary with time.
- Vary in severity and type.
- Improve with time.
- Get worse due to extreme temperatures.
The exact cause of tics is not known. As per some studies, it has been noticed that some it may happen due to certain gene mutations. Brain chemistry also plays an important role, especially the chemicals of the brain dopamine, serotonin, and glutamate.
Tics which have a direct cause are diagnosed in a different way. These tics occur due to:
- head injuries
- other injuries
Tics can be related to serious disorders including Creutzfeldt-Jakob disease or Huntington's disease. Men are prone to tics than women. Tics may have a genetic basis.
Tics are diagnosed on the basis of signs or symptoms. The symptoms must not have occurred due to other medical reasons or medicines. For tics to be diagnosed, the child must be under the age of 18 years at the appearance of symptoms. Transient tic disorders are diagnosed with the help of the presence of one or more tics appearing for less than a year in a row. Chronic vocal tic disorders or chronic motor tic disorders can be diagnosed by checking the presence of one or more tics appearing almost daily for a year or more. People with a chronic tic that is not Tourette's syndrome will experience either vocal tics or motor tics, but not both together. Tourette's syndrome is diagnosed on the basis of both vocal tics and motor tics appearing almost daily for a year or more. Mostly other behavioural concerns are present, as well. Your doctor may recommend you blood tests or other imaging tests to find out the other causes of tic disorders. Most of the children are under the age of 11 years when they are diagnosed with tic disorders.
Tic disorders do not require treatment if they are mild. If tic disorders are severe and interfering with the life of the people then treatment is required. There are many cases of tics that go away with time. On the other hand, there are some severe cases that can lead to difficulties or social problems if not treated properly on time or left untreated.
Behavioural therapy is one of the first treatment options recommended for treating tics. Your doctor may recommend you to a specialist psychological treatment service if therapy might help in your case. Habit reversal therapy is one of the main types of therapy for treating tic disorders. Exposure and response prevention or ERP is also a technique that can be used sometimes. People with tics require many sessions of these techniques with a therapist. These techniques are useful if you continue using them yourself even after the completion of the treatment.
There are some medicines that are used to control tic disorders. Check out some of the medicines that can be used in tics:
1. Neuroleptics: Neuroleptics are also known as antipsychotics. These are the main medicines taken for tics. The examples of neuroleptics are aripiprazole, pimozide, and risperidone. Constipation, blurred vision, weight gain, and dry mouth are some of the side effects of neuroleptics. Twitches, drowsiness, and shaking are some of the additional effects of some neuroleptics.
2. Other medicines: There are many medicines that can be used to minimise tics and treat conditions associated with tics. Clonidine is used to reduce tics and treat signs of ADHD or attention deficit hyperactivity disorder simultaneously. Botulinum toxin injections are given in particular muscles to prevent tics and relax muscles. The result of these injections only lasts for three months. Tetrabenazine is used to reduce tics in people who are trapped in an underlying condition that can lead to repetitive and rapid movements such as Huntington's disease. Clonazepam is a medicine used to reduce the severity of tic disorders in some of the people. There are some side effects of these treatments. You should talk to your doctor if you have any such concern.
In some severe cases of Tourette's syndrome, a type of surgery is required known as deep brain stimulation. In this, one or more electrodes are placed in an area of the brain related with tics. These are placed by using fine needles passed from the small holes in the skull.
Check out some of the complications associated with tic disorders especially in children with Tourette syndrome:
- People may experience difficulty in sleeping.
- It can lead to anxiety and depression.
- Some people with Tourette syndrome may experience attention deficit hyperactivity disorder or ADHD.
- It may lead to autism spectrum disorder.
- Tics can cause speech and language difficulties.
- OCD is one of the complications of tic disorders.
- Tic disorders can affect the self-image and self-esteem.
- It can lead to a lower quality of life.
Check out various myths associated with tic disorders:
Myth #1: Everyone who has tics also has Tourette syndrome.
Fact: Every case of tics is different. Some people experience tics for a short duration for some weeks or months. While some people may experience complex tics in one or more organs of the body that can be persistent. Each case also differs in severity. Tics can be mild and infrequent or severe and disabling. In order to be diagnosed with TS, a person must have a record of some of motor tics and one vocal tic at least with tics present intermittently for more than a year.
Myth #2: If I can’t see the tics, they must be doing better.
Fact : There is no way to prevent Tourette syndrome as it is a lifelong disorder. The symptoms of Tourette syndrome evolve with time. Some tic disorders come and go. If a person is not able to see the tics it does not mean that the person is cured or doing better.
Myth #3: Tics only occur in children.
Fact: Tourette syndrome and tics can occur in all age groups so it is a misconception that tics only occur in children. It is a fact that those tics which occur in childhood decline as one grows. On the other hand, many adults live their complete life with persistent tics in the range that varies from mild to severe.
Myth #4: People with Tourette syndrome are not as intelligent as other people.
Fact: It is a misconception or myth as people with TS can be as intelligent as other people. In most of the cases, they are highly intelligent. However, some people with TS also face learning disabilities or other comorbidities including ADHD, anxiety disorder, and OCD.
Myth #5: People with TS can control and manage their movements and sounds if they really want to.
Fact: There are some medicines and behavioural therapy treatments that can help the people to manage their tics. For the most part, vocal and physical tics related to TS are uncontrollable or involuntary such as a sneeze.
People with tics experience unwanted, irregular, repetitive, and uncontrollable movements of muscles in any organ of the body. Tics disorders are more prone in male than female. Tics can be categorised as vocal, motor, or Tourette's syndrome. Vocal and motor tics can be for a short duration or long-lasting. Tourette's syndrome is the combination of vocal tics and motor tics. Sometimes, the signs of tics may get worse due to anxiety, anger, excitement, and fatigue. Each case of tics varies in terms of severity, duration, and frequency. The exact cause of tic disorders is not known. Generally, the cases of tic disorders resolve within the time period of a year. But sometimes people may have permanent tic disorders.
You should reach out to a doctor as soon as you experience the symptoms of tic disorders. Your doctor will recommend the best treatment option as per your condition. Behavioural therapies, medicines, and surgery are some of the treatment options available for reducing tics. Behavioural therapy is the first treatment option recommended for treating tics. Habit reversal therapy is the common type of therapy used for treating tics. Exposure and response prevention or ERP is another common technique used for treating tics. Neuroleptics are the main medicines given in case of tics including aripiprazole, pimozide, and risperidone. It is important that you get the best treatment at the earliest as sometimes it can lead to various complications if left untreated.
People with tic disorders should not take a lot of stress. If a child has tic disorders then parents should not talk to their child about the problem too much otherwise it can make their situation worse. In fact, you should tell your child that there is nothing to worry about it. People have many myths or misconceptions about tics. People with Tourette syndrome are not as intelligent as other people, is one of the common myths. Many complications are associated with tic disorders. Sometimes, tics can lead to anxiety, lower quality of life, speech and language difficulties, depression, and sleep difficulties. Tic disorders are common in children with Tourette syndrome.
- What are tic disorders?
- What are the signs or symptoms of tic disorders?
- What is the exact cause of tic disorders?
- How are tic disorders diagnosed?
- How are tic disorders treated?
- What are the various complications associated with tic disorders?
- What are the various myths about tic disorders?
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