A new study has found no link between a strep throat infection and the development of tics in children who have a parent or sibling with a chronic tic disorder. The research is published in the February 2, 2022, online issue of Neurology. the medical journal of the American Academy of Neurology.
Tics are repetitive movements and vocalizations prompted by an urge to produce them. They are the defining feature of chronic tic disorders like Tourette syndrome, a neurodevelopmental disorder that begins in childhood.
“There has been much debate about whether the bacteria that causes strep throat, group A streptococcus, plays a role in the development of tic disorders, with previous research providing mixed results,” said study author Anette Eleonore Schrag, MD, PhD, of University College London in the United Kingdom. “Our research looked at a population of children at a higher risk of developing tics due to having a first-degree relative with a tic disorder and did not find an association between exposure to strep and the development of tics.”
The study involved 259 children, age three to 10, who did not have tics but who had a parent or sibling diagnosed with a chronic tic disorder. These children were tested for strep infection at the start and throughout the study, detected through throat swabs, blood tests to detect antibodies that indicate a strep infection, or a combination of these tests.
The participants were followed for an average of 1.6 years, with alternating medical evaluations either in person or over the phone every two months. Parents also kept a weekly diary and were told to report any possible sign of tics in their child as soon as possible. Tic onset was defined as the occurrence of a sudden, involuntary movement or vocalization on three or more days within a three-week period, which was always confirmed on examination.
Over the course of the study, 61 children, or 24%, developed tics. Researchers compared the frequency of tic disorders in children who had strep and those who did not and found no association between having had a strep infection and the development of tics. After adjusting for age, sex and parental education level, there was still no association.
When researchers followed up with the participants two years after the study ended, seven more children had developed tics, but researchers still found no association between tics and strep.
Independent of strep, researchers found a strong association of sex and the onset of tics, with girls having a 60% lower risk of developing tics than boys, which is similar to the findings of previous studies.
What could cause 24% of children in the study to develop tics?
Researcher Dr. Schrag said, “Future studies are needed to investigate whether pathogens other than strep, or other factors that affect the immune system, play a specific role in the development of tics.”
Comment by the Editor: It’s important to note that the study does not rule out the possibility that some children developed tics because of strep; the frequency of cases was simply not higher than for those without strep. It appears other unexamined factors were involved in triggering tics. The following quote from researcher Dr Schrag opens the door for study into other environmental issues that will hopefully include allergy, chemical sensitivity, and food reactions.
Our book Stop Your Tics by Learning What Triggers Them highlights potential triggers or causes for an increase in tics over a given time period. These types of potential triggers are typically not controlled for during studies. Excerpts from the book are included below.
Key environmental factors in health:
- Parental health; prenatal, birth, and postnatal conditions
- Food and drink
- Odors, fragrances
- Allergens: pollens, dust, molds, animals
- Seasons, temperature change
- Indoor environments
- Stress, thoughts, emotions
- Sensory input
ACN Latitudes.org often encourages anyone dealing with tics to think of twitches, jerks, and vocalizations as symptoms of an underlying illness or physical imbalance. It is not unusual for patients with a tic disorder to also experience one or more health complaints such as aches and pains, cramps, “feeling sick,” and/or sensitivity to heat, touch, or light. Digestive issues, migraine and headaches, night terrors, problems falling asleep and waking, bed-wetting, talking during sleep, visual defects, and vomiting are also common issues among those with a diagnosis of Tourette syndrome.
While avoiding triggers whenever you can, it is good to think holistically. Encourage your physician to fully explore all the symptoms that are being experienced, not just the tics. Request a referral to a specialist to address these issues, when needed. Do not overlook the possibility of an unidentified, underlying infection. In addition to exploring allergic status and diet, consider looking into possible
biochemical imbalances, toxic overloads requiring a detoxification approach, a candida overload in the digestive tract, physical asymmetry
that may be exerting abnormal pressure on nerves, and a need for nutrient supplementation.
In Natural Treatments for Tic and Tourette’s: A Patient and Family Guide, medical specialists give recommendations on strategies to address health problems that can accompany or result in tics. It is often possible to strengthen the immune system and improve resilience, with the result that some previous triggers are no longer as troublesome as they initially were. Efforts to strengthen the immune system, or reduce the level of stress response in your body, can require professional assistance. We encourage you to seek the help you need.