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Facial Tic Disorder
Facial Muscle Twitching (Tics)

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]

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]

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]

Brain surgery may also be performed as treatment. [news-medical.net]

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]

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]

Botulinum toxin helps in relaxing specific muscles and in preventing tics. The effect of this medication, however, lasts only for three months. [momjunction.com]

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]

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