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Tics are repetitive, stereotyped, involuntary movements that usually begin in childhood. They can consist of motor and vocal tics, such as excessive eye blinking/rolling, facial grimacing, neck or shoulder jerks, sniffing, throat clearing or other vocalizations. Tics can be transient or chronic.
If chronic, it may meet the criteria for Tourette syndrome. Tourette syndrome is defined as multiple motor and vocal tics that have been occurring for at least one year without more than a three-month tic-free period and diagnosed before the age of 18 years.
Tics have a waxing and waning course, which is many times exacerbated by stress, anxiety, emotional changes or fatigue. The frequency of a tic is often highest after it first arises and decreases over the following weeks, thus often tics will improve with time alone. Onset of tics can be as early as 4-6 years of age, with increasing severity during pre-puberty and puberty ages. The estimated prevalence for tics in childhood is 6-12%.
These comorbidities can sometimes provide the biggest impairment and may exacerbate tics as a result. Most of the time, tics themselves do not require management with medication, but treating these comorbid conditions may be warranted. There are some medications, for example stimulant medications, that have been reported to exacerbate tics. However, randomized controlled trials suggest that stimulants, such as methylphenidate, do not cause exacerbations more than placebo or other medications.
The most important question to consider when deciding to treat tics is, “Do the tics bother the child?” Tics may often concern parents or teachers, but if the child is not adversely impacted by the tics, treatment may not be needed.
Questions to consider:
With any treatment option, the goal is reduction in tics to a manageable level, not complete tic suppression.
Great outcomes begin with great input. Having a medical system where every department, doctor, and care team member works together means that your child can have quick access to testing, diagnosis and treatment, and that means better outcomes now and in the future. If you would like to schedule an appointment, refer a patient or speak to our staff regarding your child's tics, please call our offices at 682-885-2500.