Tics are common symptoms that occur on a continuum: They can be a minor temporary nuisance or chronic, severe and debilitating.
ACN Latitudes recommends consultation with a neurologist or other qualified physician for a definitive diagnosis when dealing with significant muscle tics. Involuntary muscular movement can be symptomatic of a number of medical conditions in addition to the diagnosis of Tourette syndrome or the general tic categories listed below. (See “Possible Related Conditions that Can Cause Tics” in this article)
Categories of Tics
Transient tic disorders: These usually begin between ages five and ten years and are estimated to affect up to 18% of children in the United States. Facial tics and eye blinking are common; the disorder can also include mild sounds or humming. Occasionally tics are unusual in nature. The tics tend to change over time, with one type of tic being replaced by another. Tic episodes usually last a few weeks or months and are most noticeable during times of stress, excitement, or fatigue. Episodes can recur over a period of several years.
Chronic tic disorders: These tics occur over many years and are relatively unchanging—such as an eye twitch that continues unchanged for years.
Chronic multiple tics: This category is difficult to distinguish from transient and chronic tics. The impression is that of having several chronic tics at once.
Tourette syndrome: This category can be the most debilitating of all tic disorders. It is described as having the following characteristics in the Diagnostic and Statistical Manual of Mental Disorders IV:
- Both multiple motor and one or more vocal tics have been present at some time during the illness, although not necessarily concurrently;
- The tics occur many times a day (usually in bouts) nearly every day or intermittently throughout a period of more than one year. During this time, there is never a tic-free period of more than three consecutive months;
- The disturbance causes marked distress or significant impairment in social, occupational, or other important areas of functioning;
- The onset occurs before 18 years; and The disturbance is not due to the direct physiological effects of a substance (eg, stimulants) or a general medical condition (eg, Huntington’s disease or post viral encephalitis).
Possible Related Conditions that Can Cause Tics
Conditions that can also cause tics include: Huntington’s disease, Sydenham’s chorea, pediatric tremors, tardive dyskinesia, cerebral palsy, Lesch-Nyhan syndrome, restless leg syndrome, dystonias, Wilson’s disease, Rett syndrome, Lyme disease, postviral encephalitis, hemiballismus, ataxias, spasmodic torticollis, benign muscle fibrillation, motor neuron diseases, neuroacanthocytosis, endocrine disorders, seizures, thyroid disease, tumors, kidney failure, multiple sclerosis, and Parkinson’s disease.
Infections like strep and Lyme (among others), as well as reactions to medications, including stimulant medications for ADHD, allergens, foods, and toxic chemicals, can all cause tics.