TICS.

Tics are more likely to be a transient experience in childhood rather than Tourettes Syndrome.

What is a tic?

A tic is an involuntary and sudden, rapid movement that is not rhythmic and is recurrent. A feeling of mounting inner tension occurs before the tic, and this feeling is relieved by the tic. A motor tic involves the muscle – for example, eye blinking, facial grimacing, shoulder shrugging, neck stretching. Vocal tics involves vocalisations – such as sniffing, grunting, and throat clearing.

It’s easy to see why the diagnosis of tics or Tourette syndrome may not be considered because symptoms such as sniffing, blinking or clearing their throat might might suggest physical causes resulting in referral to ENT surgeons for example. It’s therefore useful to be aware of the huge range of tics that might occur – also including nasal twitching, facial grimacing, head stretch or nodding, leg or feet movements, tapping.

Other vocal tics include coughing, barking, panting, hissing, moaning. The list is much longer than this. Swearing is a well known one but occurs in only about 10% of older children with Tourette’s.

The GP may spot the tic when they occur in the consulting room. However, it’s often a good idea to video the tic on your phone and show the doctor.

Complex tics may suggest a behaviour problem but are in fact tics – spitting, hopping, kicking, feet shuffling, flapping arms, twirling hair, making animal-like sounds are just a few of the possibilities.

What is the difference between Tics & Tourette Syndrome?

Lots more kids have tics than Tourette syndrome. The diagnosis of Tourette syndrome require several different ongoing tics and represents more severe and persistent tics. It is formally diagnosed with reference to diagnostic criteria (DSM V) which basically equates to the presence of at least two motor ticks and one vocal tics since childhood. Tics are therefore a lot more common than Tourette syndrome.

Tourette syndrome is surprisingly common and affects about 1% of school aged children. Tourette syndrome is four times more common boys. The average age of onset is 6 years.

The key is to consider the diagnosis in the first place – but because Tourettes and even tics were once considered quite rare, they can easily be overlooked.

The diagnosis of tourettes (and tics) does help parents understand the problem. The condition is neurodevelopmental – and is not being naughty.  There are effective treatments out there.

The key is to consider the diagnosis in the first place – but because Tourettes and even tics were once considered quite rare, they can easily be overlooked.

Who should I see about my child’s tics?

Your GP will refer you to a paediatrician with an interest in tics.

WRITTEN BY: Dr Richard Beatty
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