Tics

Definition
A tic is a sudden, repetitive, nonrhythmic motor movement or vocalization involving discrete
muscle groups. Tics can be invisible to the observer, such as abdominal tensing or toe crunching.
Common motor and phonic tics are, respectively, eye blinking and throat clearing.
The most notable tic disorder is Tourette syndrome, in which physical and vocal tics occur at the
same time. Transient tic disorder also involves both types of tics, but they often occur individually.

Symptoms
Tic disorders include Tourette syndrome (neurological disorder characterized by
repetitive, stereotyped, involuntary movements and vocalizations called tics), chronic motor or
vocal tic disorder, and transient tic disorder. Your doctor may diagnose you with tic disorder not
otherwise specified if your symptoms do not fall into those categories.
Tics are often confused with nervous behavior. They intensify during periods of
stress and do not happen during sleep. Tics occur repeatedly, but they do not usually have a
rhythm.
People with tics may uncontrollably raise their eyebrows, shrug their
shoulders, flare their nostrils, or clench their fists. These are physical tics. Sometimes, a tic can
cause you to repeatedly clear your throat, click your tongue, or make a certain noise, such as a
grunt or a moan
.

Causes
There is no known cause of transient tic disorder. Like Tourette and other tic disorders, it
is probably influenced by a combination of factors.
Some research indicates that tic disorders may be inherited. According to the Mayo
Clinic, a genetic mutation has been identified as a cause of Tourette syndrome in rare cases
(Mayo, 2012).
Abnormalities in the brain may also be responsible for tic disorders. Such abnormalities
are the cause of other mental conditions, such as depression and attention-deficit hyperactivity
disorder (ADHD).
Some research suggests that transient tic disorder could be linked to neurotransmitters.
Neurotransmitters are the chemicals in the brain that transmit nerve signals to your cells.
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However, no studies offer complete proof of the role neurotransmitters play. Medications to treat
transient tic disorder are designed to alter neurotransmitter levels.

Treatment
Transient tic disorder often goes away without treatment in children. It is important that
family members and teachers do not call attention to the tics. This can make the child more selfconscious and aggravate his or her symptoms.
A combination of therapy and medication may help in situations where the tics affect
work or school. Because stress can make tics worse or more frequent, techniques to control and
manage stress are important.
Cognitive behavioral therapy is also a useful way to treat tic disorders. During these
sessions, a patient learns to avoid self-destructive actions by controlling his or her emotions,
behaviors, and thoughts.
Medication cannot completely cure tic disorders, but it can ease symptoms for some
people. Your doctor may prescribe a drug that reduces the dopamine in your brain, such as
fluphenazine, haloperidol, or pimozide. Dopamine is a neurotransmitter that may be linked to
tics.

Tourette Syndrome

Tourette (or Tourettes) syndrome is a neurological disorder that causes repeated,

involuntary physical tics and vocal outbursts. It is the most severe of the tic syndromes. Tics are
quasi-voluntary muscles spasms. They consist of abrupt intermittent twitches of a group of
muscles. Most frequent forms are blinking, sniffing, grimacing, shoulder movements and head
movements.
The exact cause of this disorder is unknown. Tourette patients may receive
psychotherapy (one-on-one counseling with a licensed mental health professional).
Psychotherapy can also help ease symptoms of ADHD, OCD, and anxiety. Hypnosis,
relaxation techniques, guided meditation, and deep breathing may be utilized
during therapy sessions. Patients may also find help in group therapy, where they
will receive counseling with others in the same age group who are also dealing with
Tourette.
Medications

Neuroleptic drugs, such as haloperidol, may block dopamine receptors in

the brain. These drugs help to control tics. Side effects include weight gain
and mental fogginess. The antipsychotic, chlorpromazine, also known as
thorazine has been used. Anti-parkinsonian drugs may also be helpful as they
are involved in dopamine pathways.
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Botox injections in the affected muscles may help with simple motor and
vocal tics.

Stimulant medications, such as Ritalin, may reduce symptoms of ADHD

without increasing tics.

Blood pressure medications, such as clonidine, may help to control rage

attacks and also help with impulse control. Side effects are sedation and
sleepiness.

Antidepressants, such as Prozac, may help to control obsessive-compulsive

behavior.