Blinking eyes, biting lips, shrugs, tics, these uncontrolled movements affect both adults and children. What are the causes ? Are there any treatments? 

Tics are sudden, unnecessary muscle movements. They are repetitive, fluctuating, polymorphic and uncontrollable and mainly affect the face. Tics are not the result of a disease but can be a symptom of other pathologies such as Gilles de la Tourette syndrome. They are amplified during times of anxiety, anger and stress.

Between 3 and 15% of children are affected with a predominance in boys. They generally appear between 4 and 8 years old, so-called vocal or sound tics appearing later than motor tics. Their severity is often maximum between the ages of 8 and 12 years. Tics, frequent in children, disappear in half of the subjects around the age of 18. These tics are called transient, while tics that persist into adulthood are called “chronic”.

Tics can appear during periods of change such as:

• back to school,
• moving house,
• stressful period.

The environment can also play a role since certain tics are acquired by mimicry with the close entourage. Tics are made worse by stress and lack of sleep.

Some researchers hypothesize that the tics are caused by a problem with neuronal maturity. This origin could explain the disappearance of most tics in adulthood, but is not yet scientifically proven.

There are different categories of tics:

• motors,
• vocal,
• simple
• .

Simple tics

Simple tics are manifested by sudden movements or sounds, brief, but generally requiring the mobilization of only one muscle (blinking of the eyes, clearing of the throat).

Complex motor tics

The complex motor tics are coordinated. They “involve several muscles and have a particular temporality: they look like normal complex movements but their repetitive nature makes them significant” explains Dr. Francine Lussier, neuropsychologist and author of the book “Tics? OCD? Explosive crises? ”. These are, for example, movements such as repetitive shaking of the head, swings, jumps, repetitions of the gestures of others (echopraxia), or the realization of obscene gestures (copropraxia).

Complex vocal tics 

“Complex vocal tics are characterized by elaborate sound sequences but placed in an inappropriate context: repetition of syllables, atypical language, blockage that suggests stuttering, repetition of one’s own words (palilalia), repetition of words heard ( echolalia), pronunciation of obscene words (coprolalia) ”according to the French Society of Pediatrics.

The frequency of Gilles de la Tourette syndrome is much lower than that of tics and affects 0,5% to 3% of children. It is a neurological disease with a genetic component. It manifests itself by motor tics and at least one sound tic which develop during childhood and persist throughout life to varying degrees of perception. This syndrome is often associated with obsessive-compulsive disorders (OCDs), attention disorders, attention difficulties, anxiety, conduct disorders. 

However, adults, like children, can suffer from chronic tics without being diagnosed Gilles de la Tourette. “Simple tics are not necessarily the sign of Gilles de la Tourette syndrome, they are generally benign” reassures the neuropsychologist.

OCDs

OCDs or obsessive-compulsive disorders are repetitive and irrational but irrepressible behaviors. According to INSERM (National Institute of Health and Medical Research) “people who suffer from OCD are obsessed with cleanliness, order, symmetry or are invaded by doubts and irrational fears. To reduce their anxiety, they perform rituals of tidying up, washing or checking for several hours each day in severe cases ”. An OCD is a routine that should not change for the patient, while a tic is spontaneous and random and evolves over time.

Tics

Unlike OCDs, tics are involuntary movements but without the obsessive idea. These obsessive disorders affect around 2% of the population and begin in 65% of cases before the age of 25. They can be treated by taking an anti-depressant but also require the help of a psychotherapist. The therapies mainly aim to reduce the symptoms, to allow a normal daily life and to reduce the loss of time linked to the repeated practice of the rituals.

Tics usually go away after a year. Beyond this limit, they can become chronic, therefore harmless, or be a warning sign of pathology. It may be advisable in this case to consult a neurologist or a child psychiatrist, in particular if the tics are accompanied by other signs such as disturbances in attention, hyperactivity or OCDs. If in doubt, it is possible to perform an electroencephalogram (EEG).

Find the cause of tics

“We must not punish, or seek to penalize the child suffering from tics: that will only make him more nervous and increase his tics” specifies Francine Lussier. The important thing is to reassure the child and look for the elements that are a source of tension and stress. As the movements are involuntary, it is important to sensitize the patient’s family and entourage.

Provide psychological support

Psychological support can be offered as well as behavioral therapy for older people. Be careful, however: “pharmacological treatment must remain an exception” specifies the French Society of Pediatrics. Treatment is necessary when tics are disabling, painful or socially disadvantageous. It is then possible to prescribe a treatment with Clonidine. In the event of hyperactivity and associated disturbances in attention, methylphenidate may be offered. In cases of conduct disorders, risperidone is useful. If the patient has invasive OCDs, sertraline is suggested. 

Practice relaxation

It is also possible to decrease the incidence of tics by doing relaxation, practicing a sports activity, playing an instrument. The tics can possibly be controllable during very short moments but at the cost of an extreme concentration. They end up resurfacing anyway soon after.