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VERIFIED CONTENTAuthor: lek. Tomasz Nęcki

Tics are involuntary, repetitive movements such as shaking the head, grunting, blinking, or raising the arms. Not all nervous tics require treatment, but if their presence significantly disturbs school or professional functioning, it is worthwhile to go to psychotherapy or start pharmacological treatment. What are the causes of nervous tics?

What are nervous tics and how do they manifest themselves?

Nervous ticsare repetitive, involuntary movements of a part of the body. Movements of this type may concern various muscles - e.g. the hand, eye or face, but also the muscles involved in the formation of the voice. Nervous tics can occur at any age, but are most common in children and adolescents. Taking into account gender, tics are more common in men.

Nervous tics are involuntary movements, but most patients experience certain sensations that allow them to conclude that the tic is about to occur. It may be a feeling of inner tension or another unpleasant feeling, compared by patients, for example, to itchy skin and the related desire to scratch. The discomfort may increase as you try to hold back from a nervous tic.

Tics can appear at any time, but it is noted that they usually disappear during sleep and when the patient is focused on a task. The reverse situation occurs when the patient is resting - then the frequency of the appearance of the tic may increase.

Types of nervous tics

The basic division of tics is based on the type of activity repeated by the patient. For this reason, there are motor and vocal tics.

Movement ticks

Motor ticscan appear in different parts of the body. Within this category, simple and complex motor tics are distinguished. Examples of simple motor tics are:

  • shrug shoulders,
  • head shake,
  • moving the tongue (e.g. its involuntary extension),
  • blinking eyelids,
  • finger snaps,
  • rolling eyes.

As its name suggests, complex motor tics are activities in which several muscle groups are involved. Patients in this situation may include:

  • complex grimaces on the face,
  • honing clothes,
  • making obscene or forbidden gestures (copropraxia),
  • involuntary imitation of other people's movements and activities (echopraxia),
  • touching other people or objects.

Vocal tics

The second type of nervous tics arevocal tics . Like the ones described above, vocal tics are also divided into simple and complex. Simple vocal tics are repetitive ones:

  • cough,
  • grunting,
  • nose sniffing,
  • snorting,
  • hissing.

Vocal tics can also be complex. In this case, the patient may involuntarily repeat complex sounds, but also specific words or even whole sentences. Although this is a rare situation, the content expressed by the patient may be socially unacceptable, e.g. take the form of profanity.

Nervous tics: causes

Nervous tics can appear for no specific, tangible reason. This is what happens in children, in whom tic disorders may present at some point in their lives (usually during adolescence), followed by a (most often spontaneous) recovery from these involuntary motor activities. Tics that have disappeared for a while, however, can recur, even in adulthood. This situation can particularly affect patients with Tourette's syndrome: in these people, the tics may go away on their own for a long time, and then - even without any specific, apparent reason - reappear.

The cause of tics may be genetic conditions. There is a family history of nervous tics. This does not mean, however, that if a parent develops a tic in the form of, for example, a shrug, the child will suffer from the same discomfort - the tendency to tic itself may be inherited, not a specific tic.

What diseases can tics occur?

Tics can occur in the course of various diseases, they are observed in the course of:

  • Huntington's disease,
  • cerebral palsy,
  • of Tourette's syndrome,
  • Parkinson's disease,
  • conditions associated with ischemia of the central nervous system.

The cause of tics is also both the use and withdrawal of psychoactive substances. Cocaine and amphetamines are examples of agents that may be associated with the emergence of the described involuntary movements. Patients with nervous tics should avoid certain situations that may lead to more frequent occurrence of these involuntary movements. Such an action may be exerted by:anxiety, severe stress and considerable exhaustion.

Stress is considered to be one of the most important factors related to the appearance of tics (hence the name of the disorder, that is, "nervous" tics). Emotions themselves are hardly the cause of involuntary movements, but there is a link between the patient's feelings and the frequency of tics. Nervous tics can trigger any emotions of significant intensity, both negative (such as stress, anxiety or fear) and positive (e.g. euphoria).

The relationship between stress and tics may also be convinced by what patients experience when trying to contain a tic. An attempt to control involuntary movement can be a very stressful factor and it is precisely this stress that - paradoxically - can increase the intensity of the tic.

Nervous tics in children - observation

It is important to observe children with nervous tics. Based on the frequency of the occurrence of involuntary movement, it is possible to make some basic assessment of the mental state of a minor patient. A child whose tics began to appear more frequently than before is likely to face some difficulties - not coping with their own emotions, experiencing significant stress, the source of which may be both a difficult family situation and problems at school.

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Nervous tics in a child: how to deal with them?

The emergence of nervous tics in a child certainly worries the parents. However, they should be reassured - most of the tic disorders that occur before the patient reaches the age of majority, resolve spontaneously. A child with tics may, however, arouse interest in the environment or be ridiculed by peers. So what should be done in the event of tics in a child? First, the child is not always aware that he or she has tics. In such a situation, it would be best not to draw his attention to this fact. You should definitely not try to force the child to stop performing a given physical activity - this may result in the emergence of stress and anxiety in the minor, and these factors, as mentioned earlier, can only increase the frequency of tics. In a situation where the child is aware of the presence of tics, first of all, support him / her. Parents should explain to the child what his ailment is and make him aware that his mental state is not abnormal.

Nervous tics: treatment

If the presence of tics does not impair the life of the patient experiencing them, thentreatment of the disorder is not required. In a situation where the appearance of involuntary movements the patient experiences some difficulties, it is possible to take several different actions - the basic ones can be implemented by the patient himself, others include psychotherapy and (in the most advanced cases) pharmacotherapy.

Nervous tic treatment - relaxation

A patient with tics can reduce their incidence by reducing the triggers for this type of movement. They should avoid significant stress and, if they do, try to deal with it. Various types of relaxation exercises can be helpful in this case. Patients should also avoid fatigue.

Treating nervous tics - psychotherapy

Psychotherapeutic interactions used in the treatment of tic disorders are based primarily on behavioral techniques. The basic one is habit reversal therapy (HRT). In therapy, the patient expecting a tic moves in the opposite direction to the one he experiences during the tic. As an example, the tic of raising your arms can be counteracted by stretching your arms out in front of you.

Treatment of nervous tics - pharmacotherapy

Pharmacotherapy in the treatment of tics is implemented only when movement disorders significantly impair the patient's life and when they cannot be controlled by other methods. In this case, drugs such as:

  • neuroleptics (also known as antipsychotics) e.g. risperidone,
  • benzodiazepines, e.g. clonazepam,
  • alpha-2-adrenergic agonists, e.g. clonidine,
  • tetrabenazine.

In some patients, botulinum toxin injections are helpful - however, they allow to get rid of tics only for about 3 months, after which the injections have to be repeated. In the case of tics appearing in patients with Tourette's syndrome, sometimes electrode implantation into the skull is carried out, whose task is to modify the electrical activity of the brain (the so-called deep brain stimulation).

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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