Facial tics
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Alternative names
Tic - facial; Mimic spasm
Definition
A facial tic is a repetitive, spasmodic movement often involving the eyes and facial muscles.
Causes, incidence, and risk factors
Tics most often occur in children, but may persist into adulthood in some cases. Tics occur 3 to 4 times as often in boys as girls. Tics may affect as many as one-fourth of all children at some time. The cause of tics is unknown, but stress appears to increase the severity of already established tics.
Short lived or transient tics are common in childhood and may appear and disappear within a matter of weeks or months (transient tic disorder). These tics often involve the eyes or facial muscles. The most commonly seen facial tics are repetitive eye blinking, squinting, wrinkling of the nose, and twitches around the mouth. Repetitive throat clearing or deep, throaty sounds or grunts may also be considered tics.
Certain medications, such as methylphenidate (used to treat hyperactivity in children), were previously thought to precipitate tics in children already prone to the disorder. However, recent studies published do not support this notion and suggest that these medications can be used in children with tics who also have attention deficit disorder, which commonly occurs in the same population.
A chronic motor tic disorder also exists. It may last for years. This form is extremely rare compared to the common short-lived childhood tic. Gilles de la Tourette syndrome is a separate condition in which tics are a predominant symptom.
Symptoms
- Repetitive, involuntary spasmodic muscle movements, such as:
o eye blinking
o squinting
o nose wrinkling
o mouth twitches
o facial grimacing
- Repetitive throat clearing or grunting
Signs and tests
A tic is generally diagnosed during a physical examination. No special tests are necessary. Rarely, an individual may require an EEG to rule out seizures or seizure-type activity.
Treatment
Transient childhood tics are not treated. Calling the child’s attention to a tic may increase its severity or prolong its disappearance. A non-stressful environment is helpful in both decreasing the frequency of a tic, and hastening its disappearance.
If tics are disabling, medications such as Risperidone (as well as others) may be effective in controlling the tics.
Expectations (prognosis)
Simple childhood tics can be expected to disappear spontaneously over a period of months. Chronic tics may last indefinitely.
Complications
In most cases, there are no complications.
Calling your health care provider
Call for an appointment with your health care provider if tics are severe, affect multiple muscle groups, or are persistent.
Prevention
Many cases are not preventable. Reducing stress may be helpful, and sometimes counseling is advised to help the child learn how to cope with stress.
by Harutyun Medina, M.D.
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