A Comprehensive Guide to Understanding and Managing Tic Disorders

Tics are repetitive movements of sounds that your body makes involuntarily and are common in childhood. Most times that are mild and go away on their own. However, if your child has severe or frequent tics, they must be having a neurological condition causing them to perform tics. This is called a tic disorder. 

Tic disorders start in childhood, as early as 5 years of age. It is more common among males than females. Many cases of tics are temporary and resolve within a year. But some people develop a chronic disorder, which affects about 1 out of 100. Keep reading the blog to explore the types of tic disorders, causes, and treatment. 

What are the types of tics disorders?

Tic disorders are classified as motor, vocal, or Tourette’s syndrome. Motor and vocal tics are short-lived or chronic. But Tourette’s is a chronic tic disorder. 

1. Transient tic disorder: Transient tic disorder affects up to 10% of children during early school years. Children with transient tic disorder will present with one or more tics for a month, but for less than 12 consecutive months. The onset of the tics must have been prior to the individual turning 18 years of age. 

Motor tics are seen more in cases of transient tic disorder than vocal tics. Tics vary in type and severity over time. Research suggests that tics are common among children with learning disabilities and are seen in special education classrooms. 

2. Chronic motor or vocal tic disorder: Tics that appear before the age of 18 and last for 1 year or more are known as chronic tic disorder. These can be motor or vocal. But these cannot be both. Chronic tic disorder is less common and has affected 1 percent of children. 

If the child is younger at the onset of a conic motor or vocal tic disorder, they have a higher chance of recovery. Tics tend to disappear within 6 years.

3. Tourette’s syndrome: Tourette’s syndrome is a neurological disorder. It is characterized by tics, both motor and vocal. It is the most severe type, yet the least common. The exact number of people with TS is not known. Studies suggest that half of all children with the condition are not diagnosed. 

0.3% of children are aged between 6 and are accompanied by other conditions such as attention deficit hyperactivity disorder and obsessive-compulsive disorder.  17 have been diagnosed with TS. The symptoms of TS vary in their severity. For many people, symptoms tend to improve with age. TS is accompanied by other conditions such as attention deficit hyperactivity disorder and obsessive-compulsive disorder. 

What are the symptoms of tic disorders?

The tic disorders symptoms are mentioned below: 

• Motor tics: These include tics such as head and shoulder movements. This includes clicking fingers, banging, and jerking. Motor tics tend to appear before vocal tics. 
• Vocal tics: These are sounds such as throat clearing, coughing, or grunting. 
• Tics can be divided into the following categories: 
• Simple tics: These are fleeting tics that use few muscle groups. Examples include eye darting or throat clearing. 
• Complex tics: This involves coordinated movements that use distinct muscle groups. The examples include stepping in a certain way or hopping. 

Tics are preceded by an itch or tingle. It is possible to hold back but needs a lot of effort. You will experience relief after removing the tic. 

The symptoms of the tic disorders are: 

• Worsen with emotions such as excitement, anger, and fatigue
• Can worsen during periods of illness
• Vary over time
• Occur during sleep 
• Improve over time

What are the causes and risk factors?

The cause of tic disorders is unknown. Recent studies have identified some gene mutations that may play a role. Additionally, brain chemistry is also crucial. This includes brain chemicals glutamate, dopamine, and serotonin. Tics that have a direct cause into different categories of diagnosis. These include tics due to the following reasons: 

• Stroke 
• Poisons 
• Surgery 
• Head injuries 
• Infections 
• And other injuries 

Additionally, tics can be associated with more serious medical disorders such as Creutzfeldt-Jakob disease or Hunington’s disease. 

The risk factors include the following: 

• Genetics: Tics can be genetic and run in families. Then there may be a genetic basis to these disorders. 
• Sex: Men are likely to be affected more than females. 

What are the complications?

The conditions that are associated with tic disorders include the following: 

• Depression 
• ADHD
• Anxiety 
• Autism spectrum disorder 
• OCD
• Sleep difficulties 
• Speech and language difficulties 
• Learning difficulties 

It may also hamper self-esteem and self-image. Some studies have also found that children with TS or other chronic tic disorders often experience a lower quality of life as compared to those without one of these conditions. 

What is the treatment involved?

Tic disorders are diagnosed based on the symptoms and signs. The child must be under 18 years of age. Additionally, the symptoms must not be caused by any other medical conditions or drugs. While there is no cure, treatments reduce the frequency and the intensity of tics. Here are the treatments involved: 

1. Behavioral therapy: The most commonly used therapy is comprehensive behavioral intervention for tics. It teaches individuals to recognize the urge before a tic happens and use competing responses to lessen or control the tic. CBIT includes relaxation techniques that help manage stress. This can trigger tics. 
2. Lifestyle medications: reducing stress through relaxation techniques, proper sleep routines, and exercise can help in managing tics. Stress is a known trigger, and hence teaching relaxation strategies can reduce the frequency of tics. 
3. Deep brain stimulation: In severe cases where other treatments do not work, DBS may be an option. This process implants a device in the brain that sends electrical signals to abnormal brain activity. This helps to reduce or eliminate tics.

Living with tic disorders

Living with tic disorders is quite challenging, but when you use the right strategies, individuals can lead fulfilling lives. Tics may affect self-esteem and make it difficult to interact socially. However, they can be managed and supported. Behavioral therapies such as CBIT teach ways to control tics. Medications can also help recur the severity. Take help from family and friends to manage the symptoms. 

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