A tic is a problem
in which a part of the body moves repeatedly, quickly, suddenly and
uncontrollably. Tics can occur in any body part, such as the face,
shoulders, hands or legs.
Sounds that are made involuntarily (such as throat clearing) are called
vocal tics. Most tics are mild and hardly noticeable. However, in
some cases they are frequent and severe, and can affect many areas
of a child's life.
The patient has vocal or motor tics,or both. They can be single or
multiple.
For at
least 4 weeks but no longer than 12 consecutive months, these tics
have occurred many times each day, nearly every day.
These
symptoms cause marked distress or materially impair work, social or
personal functioning.
They began
before age 18.
The symptoms
are not directly caused by a general medical condition (such as Huntington's
disease or a postviral encephalitis) or to substance use (such as
a CNS stimulant).
The patient
has never fulfilled criteria for Tourette's
Disorder or Chronic Motor or Vocal
Tic Disorder.
Associated
Features
Differential
Diagnosis:
Some disorders
have similar or even the same symptoms. The clinician, therefore,
in his/her diagnostic, attempt has to differentiate against the
following disorders which need to be ruled out to establish a
precise diagnosis. In Tourette's Disorder and Chronic Motor or
Vocal Tic Disorder, the duration of the disturbance is at least
one year
Cause:
Transient tic
disorder is common in children. Five to twenty four percent of all
school age children have had tics at some stage during this period.
The cause of transient tic disorder or short-lived, temporary tic,
is either organic or psychogenic. The child may have facial tics or
tics involving movement of the arms, legs, or other areas. Tics appear
to get worse with emotional stress and are absent while sleeping.
Treatment:
Clinicians recommend the family pay no attention to the tics at first,
since unwanted attention may reinforce the frequency of the tics.
Counseling
and Psychotherapy [ See
Therapy Section ]:
If tics are severe
to cause problems in school or occupational functioning, then behavioral
techniques are recommended.
Pharmacotherapy
[ See Psychopharmacology
Section ] :
Tics may be precipitated
in with ADHD when they are given methylphenidate (Ritalin). This antihyperactive
drug does not cause the tic but precipitates it. Withdrawal of the
drug, however, may not stop the tic once it has been initiated.
