Tics

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KEY POINTS

• Tics are muscle movements or sounds that you make without meaning to do so.
• Tics may happen more often when you are tired, tense, or stressed. Many tics are not harmful and get better on their own.
• Tics that don’t go away can be treated with relaxation techniques or biofeedback.

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What are tics?

Tics are muscle movements or sounds that you make without meaning to do so. Tics are hard to stop or control. Some people are able to hold back their tics briefly, but usually not for long. If tics are severe, or happen often, they can affect your life in many ways. The tics may go away after a time or you may keep having the tics all of your life.

There are different kinds of tics.

• Motor tics are brief, rapid movements of the face, hands, or legs that happen over and over.
• Vocal tics can be words, throat clearing, or other sounds that are not made on purpose.

Tics may involve just a single muscle group, such as eye blinking or sticking out the tongue. Or they may include multiple muscle groups in a coordinated movement such as jumping, head shaking, or throwing an object.

Tourette syndrome (TS) is a type of tic disorder that can cause both motor and vocal tics. It usually starts in early childhood and is usually lifelong, though the symptoms may decrease as you get older.

What is the cause?

The exact cause of tics is not known. They tend to run in families. Tics may be caused by:

• Caffeine
• Head injury
• Damage to a nerve in the face
• A seizure disorder
• A brain disease, tumor, or stroke
• Carbon monoxide poisoning
• Not enough magnesium in the diet
• Pain in the face or teeth
• Some stimulant medicines
• Stress, fatigue, or anxiety

Some tic problems may start or get worse after a strep infection.

What are the symptoms?

Symptoms may include:

• Eye twitches or very fast eye blinks
• Wrinkling the nose
• Sticking out or biting the tongue
• Shoulder shrugging
• Head jerks
• Kicking
• Grunting, throat clearing, or sniffling

You may have one type of tic or many different tics. The tic may start in one body part and spread to other body parts. Between tics, you may have a feeling of relief until you feel the need to have another tic. You may have trouble paying attention and concentrating because you are distracted by your tics.

How are they diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You may have tests or scans to check for possible causes of the symptoms, such as a seizure disorder.

How are they treated?

Many tics are not harmful and get better on their own. Usually you will have more tics when you are tense or stressed and fewer tics when you are asleep, relaxed, or focused on an absorbing task. The use of relaxation techniques or biofeedback may help relieve stress and reduce tics.

Tic disorders that don’t go away on their own and greatly affect daily activities may be treated with medicine. Comprehensive Behavioral Intervention for Tics (CBIT), which includes habit reversal training and other therapies, may also help. With habit reversal training, you do something instead of the tic. The new action should use muscles in a way that makes it impossible to do the old habit. For example, instead of an eye blink tic, you could very gently close your eyelids and hold them closed for 10 seconds.

Depending on the cause, surgery may be done on facial nerves or muscles for severe tics.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example, take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. If you want to drink alcohol, ask your provider how much is safe for you to drink. Exercise according to your healthcare provider's instructions.

Ask your provider:

• How and when you will get your test results
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.