What are tics?
The tics are motor movements or involuntary, fast, sudden, recurrent, stereotyped and not rhythmic vocalizations. We can differentiate between complex and simple tics.
- Complex tics: they involve diverse groups of muscles, they can include facial grimaces combined with twisting of the head and shrugging of shoulders or words and phrases, with an approximate duration of two seconds.
- Simple tics: involve a few muscles or simple sounds, with a duration of a few tenths of a second.
In children and adolescents, tic disorders are relatively frequent behaviors that change in both intensity and frequency over time.
To diagnose tics, the specialists rely essentially on the family history, the clinical history and the physical examination.
How frequent are tics?
As much the frequency as the discomfort that they can generate usually depend according to situational and temporary variables.
Normally, the tics diminish when the person sleeps, is before the presence of strangers or realizes absorbing activities not anxiogenic.
On the other hand, they are accustomed to increase in moments of stress or excessive anxiety, anger, fatigue, with very close people or in solitude.
How do tics evolve?
Although the evolution is unpredictable, normally the most serious period is during the first phase of the adolescence. During the first years of adult age, the majority of patients reduce the presence of tics or even disappear.
The prevalence of such tics is estimated to be between 4 and 24 percent, varying according to different studies and areas, but being more common in males.
Which are the causes of the tics?
We can distinguish four factors to consider:
- Perinatal: prematurity, pregnancy stress, low birth weight, forceps delivery, tobacco and alcohol consumption during pregnancy.
- Postinfectious autoimmune: after streptococcal tonsillar infection.
- Neuroanatomical: anomalies in the basal ganglia and in the thalamic-cortical cortico-striatal system.
- Psychic: exacerbation in situations of insomnia or stress.
How do tics affect a child?
The tics usually cause a high degree of interference in the daily life of a child. This one can be stigmatized, mocked or rejected by its companions, in addition to pressured not to make tics by relatives or teachers.
Due to the impossibility to control the tics, added to the other aspects, they can cause great difficulties in the social, academic and emotional development of the child. For these reasons, it is vital to intervene quickly at the moment that these tics are detected, which usually become chronic.
There are different types of intervention: psychological, psychoeducational and pharmacological.
What are the symptoms we should pay attention to?
There are different signs that we can identify in children or adolescents, among which we find:
- Nose wrinkling
- Raising the shoulders
- Repetitive blinking
- Throat clearing
- Taking steps backwards
- Gesturing with hands
- Sniffing
- Turning in on oneself while walking
- Pulling out hair
- Blowing
- Repeating the last sound, phrase or word heard (echolalia)
- Nail biting
- Suddenly uttering an obscene word or phrase (coprolalia)
- Whistling
- Repeating one’s own sounds or words (palilalia)
For more information on tics contact a specialist in Child Psychiatry.