Presentation
Table 3 Previously reported cases of idiopathic tic disorders occurring during adulthood The present series of 22 patients is the largest report describing the clinical features of tic disorders presenting during adulthood. [jnnp.bmj.com]
Some tics resolve spontaneously and do not require any treatment while other tics have a variable (i.e., type of tics changes but tics always present) or chronic (i.e., same tic always present) presentation. [talbotpsychology.com.au]
Chronic tic disorder was either single or multiple motor or phonic tics, but not both, which were present for more than a year. Tourette syndrome was diagnosed when both motor and phonic tics were present for more than a year. [en.wikipedia.org]
Transient Tic Disorder The tics (motor and/or vocal) are present for more than 4 weeks, but less than 12 months. Chronic Motor or Vocal Tic Disorder The tics (motor OR vocal) are present for more than 12 months. [childpsychiatryny.com]
Tourette Syndrome : “have two or more motor tics” that have been present, along with at least one vocal tic. [movementdisorders.ufhealth.org]
Entire Body System
- Epilepsy
August 01, 2016 Differential Diagnosis: Tic Disorders vs Myoclonic Epilepsy Though juvenile myoclonic epilepsy (JME) is the most common form of idiopathic generalized epilepsy, it is frequently misdiagnosed or overlooked. [neurologyadvisor.com]
Epilepsy & Seizures Quiz: What Causes Seizures? Do you know the difference between seizures and epilepsy? What are the types of seizures? Take the Epilepsy & Seizures Quiz to... [medicinenet.com]
Is This Epilepsy? Many parents fear that a child with a tic disorder will have epilepsy. Remember that not all children with epilepsy experience the dramatic grand mal (or tonic-clonic) seizures. [nobullying.com]
We show here that, although the patients died about 2000 years ago, the probability that they had focal epilepsy, hemiplegic migraine, deviation of the visual axes (tropia), corectopia, and autonomic nervous system dysfunction is very high. [jnnp.bmj.com]
Anti-seizure drugs typically used for epilepsy, such as topiramate (Topamax), have proven helpful for some TS patients. [22] Community Q&A Add New Question Question Can my son withdraw from his medication for TS? He is on concerta and catapres. [wikihow.com]
Respiratoric
- Cough
To avoid interrupting the musicians, people might try very hard not to cough until the intermission. When they finally cough, however, they might cough several times instead of just once or twice. [humanillnesses.com]
Have you ever felt a cough coming on and tried to avoid it? Didn't work out so well, did it? Chances are it was much worse. Tics are very similar. A tic? What tic? If a friend of yours has a tic, don't call attention to it. [kidshealth.org]
Simple vocal tics: These simple sounds can include sniffing, throat clearing, grunting or coughing. [drkaylenehenderson.com]
A simple phonic tic can be almost any possible sound or noise, with common vocal tics being throat clearing, coughing, sniffing, or grunting. Complex motor tics are typically more purposeful-appearing and of a longer nature. [sciencedaily.com]
Motor tics include blinking, facial or upper body movements, and vocal tics involve throat clearing, coughing, squeaking and grunting. While the exact cause of tics is still unclear, they are known to have a genetic and neurological basis. [todaysparent.com]
Gastrointestinal
- Nausea
Beta blockers like Propranolol may cause slowed heart rate, light-headedness, depression and nausea. Benzodiazepines lead to drowsiness, and fatigue. Anti-seizure medications may cause lack of coordination and balance, nausea, dizziness and fatigue. [news-medical.net]
These drugs can be successful in treating mild cases but cause side effects (e.g., drowsiness, unsteadiness, nausea, skin rash, dependence). [mayfieldclinic.com]
The SSRIs, however, can cause gastric upset and nausea. Benzodiazepines are used in some cases to lower the patient's anxiety level, but are often avoided because they can cause dependence and tolerance. [minddisorders.com]
’. panic attack A sudden attack of panic and intense fear not always with an obvious trigger, usually including hyperventilating, shortness of breath, chest pains, dizziness, shaking, feeling very hot, sweating, increased heartbeat, small blackouts, nausea [multiconnection.tripod.com]
Potential epigenetic risk factors ( heritable changes in gene activity that are not caused by changes in the DNA sequence) that have been suggested include the timing of perinatal care, severity of mother’s nausea and vomiting during the pregnancy, low [childneurologyfoundation.org]
- Vomiting
Going “cold turkey” from these medications can cause severe withdrawal symptoms like migraines, vomiting, fainting or seizures. Patients need to taper off these medications gradually. This has to be done under medical supervision. [nobullying.com]
Unique tics have included: vomiting and retching anterior-posterior displacement of the external ear sign language tics air swallowing palatal myoclonic movements symptoms such as immobility, staring, and posturing (“blocking” tics) Phonic a) Simple vocal [childneurologyfoundation.org]
There is some evidence that maternal emotional stress during pregnancy and severe nausea and vomiting during the first trimester may affect tic severity. Attempting to minimize prenatal stress may possibly serve a limited preventive function. [minddisorders.com]
Musculoskeletal
- Muscle Spasm
Tics are involuntary muscle spasms and can't be controlled by will. The New York Times reports that reducing stress in the environment can reduce tics and help them to go away altogether. [livestrong.com]
Botulinum toxin or botox may be used to relieve the muscle spasm. For patients with severe dystonia who have not responded to therapy surgery is considered to relieve the muscle spasm and pain. Brain surgery may also be performed as treatment. [news-medical.net]
What is hemifacial spasm? Hemifacial spasm (also called tic convulsif) is an involuntary twitching of the facial muscles on one side of the face. [mayfieldclinic.com]
Pain in the face or teeth, denture problems, or damage to the facial nerve may cause a muscle spasm. What are the symptoms? The muscle twitching in facial tics repeats in the same pattern. Tics have no apparent purpose. [kpjampang.com]
Psychiatrical
- Aggressive Behavior
Episodic outbursts (rage) and self-injurious behavior : Some individuals with TS have significant problems with labile emotion, anger control, and aggression. [childneurologyfoundation.org]
Face, Head & Neck
- Facial Grimacing
Simple facial tics like eye blinking, slight facial grimacing or slight facial twitching will usually be the first tic a child has. After a child’s first simple tic, other tics may develop in the trunk, arms and legs. [njcts.org]
Complex motor tics can include facial grimacing combined with a head twist and a shoulder shrug. Complex motor tics may actually seem purposeful but are completely involuntary. [finspeds.com]
Some common facial tics include: blinking the eyes wrinkling the nose sticking out or biting the tongue facial grimaces How do they occur? Tics often start between the ages of 7 to 9, but may start as early as age 3. [kpjampang.com]
For example, a child who at first has an eye-blinking tic might have a facial grimacing tic instead a few weeks later. [drkaylenehenderson.com]
Motor tics can be of an endless variety and may include such movements as hand-clapping, neck stretching, mouth movements, head, arm or leg jerks, and facial grimacing. [sciencedaily.com]
- Facial Tic Disorder
The severity and frequency of the tics can help determine which disorder is causing them. Transient tic disorder Transient tic disorder is diagnosed when facial tics last for a short period of time. [healthline.com]
Neurologic
- Tic Disorder
Chronic motor tic disorder Chronic motor tic disorder is less common than transient tic disorder, but more common than Tourette’s syndrome. [healthline.com]
tic disorders F95.9 Tic disorder, unspecified DSM-IV-TR [ edit ] In the fourth revision of the DSM ( DSM-IV-TR ), tic disorders were classified as follows: [4] Transient tic disorder consisted of multiple motor and/or phonic tics with duration of at [en.wikipedia.org]
Disorders, Tic disorder, TICS, TIC DISORDERS, Tic Disorder NOS, Tic disorder unspecified, Tic disorder, unspecified, Tic Disorder, Tic disorders, TIC DIS, [X]Tic disorders, tic disorder, tic disorder (diagnosis), Tic NOS, Tic Disorders [Disease/Finding [fpnotebook.com]
Diagnosis of Tic disorders There are four different types of Tic disorders: Tourette’s Disorder, Persistent (Chronic) Motor or Vocal Tic Disorder, Provisional Tic Disorder and the other specified or unspecified tic disorders. [hmhk.com.au]
- Grunting
A tic may take the form of sounds, such as clearing the throat and, less frequently, grunting noises. Shouting out words and profanities — the stereotypical image of tic disorder — is rare. [additudemag.com]
Tics may be motor or vocal; the vocal tics include humming, grunting, or saying actual words, usually in an explosive, spastic fashion, (the words may be curses). Tics may be simple or complex. [childbrain.com]
Tics can include: Twitching of the eyes Jerking of the neck Coughing Throat-clearing Yelling Grunting Tics are characterized as either simple or complex. [finspeds.com]
Tics may involve repeated, uncontrolled spasm-like muscle movements, such as: Eye blinking Grimacing Mouth twitching Nose wrinkling Squinting Repeated throat clearing or grunting may also be present. [medlineplus.gov]
Sometimes tics can be in the form of an audible sound, like throat clearing, sniffing, or grunting. It’s important for parents to understand that children cannot consciously suppress a tic. [charlotteparent.com]
- Seizure
Epilepsy & Seizures Quiz: What Causes Seizures? Do you know the difference between seizures and epilepsy? What are the types of seizures? Take the Epilepsy & Seizures Quiz to... [medicinenet.com]
“A seizure disorder of generalized myoclonic epilepsy was diagnosed and she was started on valproic acid (depakote). At the time of this writing she is ‘seizure' and ‘tic' free,” they reported. [neurologyadvisor.com]
Infantile Spasms Neonatal Seizure Disorders Tic Disorders and Tourette Syndrome in Children and Adolescents Tics are defined as repeated, sudden, rapid, nonrhythmic muscle movements including sounds or vocalizations. [merckmanuals.com]
Anti-seizure medications may cause lack of coordination and balance, nausea, dizziness and fatigue. [news-medical.net]
In rare cases, an EEG may be done to look for seizures, which can be the source of tics. Short-lived childhood tics are not treated. Calling the child's attention to a tic may make it worse or cause it to continue. [medlineplus.gov]
- Myoclonus
Because tics may resemble other movement disorders, you rule out stereotypies, dystonia, chorea, ballism, and myoclonus ( Table 1 ). [mdedge.com]
chorea, dystonia, myoclonus) must be distinguished from tics. Other conditions (e.g.; autism, stereotypic movement disorder) also include movements which may be confused with tics. [sciencedaily.com]
Provisional tic disorder 307.22 Persistent (chronic) motor or vocal tic disorder (specify motor or vocal) 307.23 Tourette's disorder Diagnosis [ edit ] Tics should be distinguished from other causes of tourettism, stereotypies, chorea, dyskinesias, myoclonus [en.wikipedia.org]
Sometimes during the interview there was a rapid stereotyped lateral jaw deviation to the left, but no other repetitive or stereotyped movements, such as tongue protrusion, sustained posturing, palatal myoclonus, or pharyngeal movements. [jnnp.bmj.com]
- Convulsions
The severity of the convulsions, or ‘tics’, varies; the discomfort by the unpredictability of the condition is universal. [thenba.ca]
Medication : Your doctor may prescribe anti-convulsant drugs such as carbamazepine (Tegretol) or phenytoin (Dilantin) to block firing of the nerve. [mayfieldclinic.com]
The 21-year-old college student had been referred after her mother observed the patient having a convulsion. [neurologyadvisor.com]
Workup
History and physical examination The first part of a medical workup for tics is the taking of a medical history and a general physical examination. [healthofchildren.com]
Treatment
Treatment may be needed if the tics interfere with social interactions, schoolwork, or job performance. [healthline.com]
Medication, surgery, and Botox injections are treatment options to stop the spasms and relieve the discomfort. Each treatment offers benefits, but each has limitations. You and your doctor should determine which treatment is best. [mayfieldclinic.com]
Brain surgery may also be performed as treatment. [news-medical.net]
The best treatment is a form of cognitive-behavioral therapy known as Habit Reversal Therapy (HRT) to treat Chronic Tic Disorders including Tourette's syndrome. The efficacy of this treatment has been shown in several adult and teen studies. [ocdtypes.com]
Treatment, then, is habituation to stimuli. Preliminary results are positive, need confirmation; Cognitive-behavioral treatment (CBT): re-structuring expectations and actions in high risk situations related to ticking behavior. [theravive.com]
Prognosis
Long Term Prognosis for Tic Disorders The long term prognosis for managing tic disorders is excellent, provided that the child has begun showing symptoms before they reach adulthood. [nobullying.com]
Prognosis In most cases, the long-term outcome is excellent. External resources American Academy of Neurology (AAN)1080 Montreal Ave.St. [drugs.com]
There is now a general consensus that if a tic disorder is the only diagnosis, the prognosis is favorable. [minddisorders.com]
Prognosis The prognosis for most tics and tic disorders is quite good. In the majority of cases, the tics diminish in severity and eventually disappear as the child grows older. [healthofchildren.com]
Etiology
Etiology is not known, but tic disorders tend to be familial. In some families, they appear in a dominant pattern with incomplete penetrance. [merckmanuals.com]
In terms of etiology, most co-morbidity, with the possible exception of obsessive compulsive disorder, is likely independent of the tic etiology. [childneurologyfoundation.org]
Etiology Tics are classified as either primary (idiopathic) or secondary. Table 5 lists secondary causes of tics. Idiopathic tic disorders and Tourette's syndrome are multifactorial in etiology. [aafp.org]
Epidemiology
The term provisional "satisfies experts with a more systematic epidemiological approach to disorders", but should not imply that treatment might not be called for. [10] Differentiation of chronic motor or vocal tic disorder: DSM-5 added a specifier to [en.wikipedia.org]
Epidemiology Tics have come to be recognized as a common component of development. [aafp.org]
CAUSATION Epidemiology: Epidemiologic studies have shown that about 20-30% of children exhibit tics in a classroom setting. The estimated prevalence (number of cases in population at a given time) of impairing cases is 1-10/1,000 individuals. [childneurologyfoundation.org]
Pathophysiology
While the pathophysiology is still partially unknown, there are some clear indicators for causes for tic disorders. Researchers, throughout the world, are still exploring the exact cause/s for a tic disorder. [movementdisorders.ufhealth.org]
Pathophysiology The precise etiology of Tourette's syndrome is unknown. Tics are believed to result from a tripartite dysfunction in the central nervous system. [aafp.org]
For many, concise information about tic characteristics, diagnosis and outcome, genetic predisposition, underlying pathophysiologic mechanisms, and availability of tic-suppressing pharmacotherapy can remove or delay the need for medication. [childneurologyfoundation.org]
Prevention
Preventing tics is better than controlling them. Giving yourself free rein in terms of your actions, thoughts and emotions can reduce tension and hyperactivation, thereby preventing tics. [iusmm.ca]
Links www.blepharospasm.org www.aanem.org/Patients Glossary anticonvulsants : drugs that stop or prevent convulsions or seizures. Used in patients with facial pain to block firing of nerves in order to control pain. [mayfieldclinic.com]
Botulinum toxin helps in relaxing specific muscles and in preventing tics. The effect of this medication, however, lasts only for three months. [momjunction.com]
Call for an appointment with your provider if tics: Affect many muscle groups Are persistent Are severe Many cases cannot be prevented. Reducing stress may be helpful. Sometimes, counseling can help your child learn how to cope with stress. [medlineplus.gov]
Prevention There is no way to prevent motor or vocal tics unless the tic was brought on by the use of stimulant drugs, in which case stopping the drug may get rid of the tic. [drugs.com]