Transient tic disorder, now known as provisional tic disorder, is a condition involving physical and verbal tics. The Diagnostic and Statistical Manual, 5th Edition (DSM-5) renamed this disorder in 2013. A tic is an abrupt, uncontrollable movement or sound that deviates from a person’s normal gestures. For example, a person with tics may blink rapidly and repeatedly, even if nothing is irritating their eyes.
Every person experiences tics differently. They may suffer from either uncontrolled movements or noises. Tics are common in children and may last for less than one year. A child with transient tic disorder has noticeable physical or vocal tics. The American Academy of Child and Adolescent Psychiatry states that tics affect up to 10 percent of children during their early school years.
The most notable tic disorder is Tourette syndrome, in which both physical and verbal tics occur in the same individual, often at the same time. Transient tic disorder also involves both types of tics, but they often occur individually.
TYPES OF TICS
Tic disorders can usually be classified as motor, vocal, or Tourette’s syndrome, which is a combination of both.
Motor and vocal tics can be short-lived (transient) or chronic. Tourette’s is considered to be a chronic tic disorder.
Transient tic disorder
Children with transient tic disorder will present with one or more tics for at least 1 month, but for less than 12 consecutive months. The onset of the tics must have been before the individual turned 18 years of age.
Motor tics are more commonly seen in cases of transient tic disorder than vocal tics. Tics may vary in type and severity over time.
Chronic motor or vocal tic disorder
Tics that appear before the age of 18 and last for 1 year or more may be classified as a chronic tic disorder. These tics can be either motor or vocal, but not both.
If the child is younger at the onset of a chronic motor or vocal tic disorder, they have a greater chance of recovery, with tics usually disappearing within 6 years. People who continue to experience symptoms beyond age 18 are less likely to see their symptoms resolved.
Tourette’s syndrome (TS) is a complex neurological disorder. It is characterized by multiple tics – both motor and vocal. It is the most severe and least common tic disorder.
The Centers for Disease Control and Prevention (CDC) report that the exact number of people with TS is unknown. CDC research suggests that half of all children with the condition are not diagnosed. Currently, 0.3 percent of children aged 6 to 17 in the United States have been diagnosed with TS.
SYMPTOMS OF TICS
The defining symptom of tic disorders is the presence of one or more tics. These tics can be classified as:
- Motor tics: These include tics, such as head and shoulder movements, blinking, jerking, banging, clicking fingers, or touching things or other people. Motor tics tend to appear before vocal tics, although this is not always the case.
- Vocal tics: These are sounds, such as coughing, throat clearing or grunting, or repeating words or phrases.
Tics can also be divided into the following categories:
- Simple tics: These are sudden and fleeting tics using few muscle groups. Examples include nose twitching, eye darting, or throat clearing.
- Complex tics: These involve coordinated movements using several muscle groups. Examples include hopping or stepping in a certain way, gesturing, or repeating words or phrases.
Tics are usually preceded by an uncomfortable urge, such as an itch or tingle. While it is possible to hold back from carrying out the tic, this requires a great deal of effort and often causes tension and stress. Relief from these sensations is experienced upon carrying out the tic.
The symptoms of tic disorders may:
- worsen with emotions, such as anxiety, excitement, anger, and fatigue
- worsen during periods of illness
- worsen with extreme temperatures
- occur during sleep
- vary over time
- vary in type and severity
- improve over time
The exact cause of tic disorders is unknown. Within Tourette’s research, recent studies have identified some specific gene mutations that may have a role. Brain chemistry also seems to be important, especially the brain chemicals glutamate, serotonin, and dopamine.
Tics that have a direct cause fit into a different category of diagnosis. These include tics due to:
- head injuries
- other injuries
RISK FACTORS OF TICS
- Genetics: Tics tend to run in families, so there may be a genetic basis to these disorders.
- Sex: Men are more likely to be affected by tic disorders than women.
COMPLICATIONS OF TICS
Conditions associated with tic disorders, especially in children with TS, include:
- autism spectrum disorder
- learning difficulties
- speech and language difficulties
- sleep difficulties
HOMOEOPATHIC TREATMENT FOR TICS
1. Agaricus Muscaris
Very useful for tics where motor tics like eye twitching, facial twitching, shaking of legs, jerking of the head, etc are preent which typically stops during sleep. There is a trembling sensation in the lips and the lower jaw area. Useful for twitching of hands which gets better while doing manual work. The child tends to have quick and hurried movements of the upper limbs. There may be jerking motions of legs.Very useful to cure tics in kids who are hyperactive and clumsy without any fear of danger.
Very useful for vocal tics where the child tends to babble all the time.There is irrelevant and endless talking, stammering, and spasmodic dysphonia (hoarseness of voice) .Also useful for muscles used for locomotion. Also useful in motor tics like twitching of hands, clapping hands overhead, shutting and an opening of hands a
4. Zincum Metallicum
Useful for muscle control and coordination.There is fidgeting of lower extremities, a restlessness of legs, keeping feet in constant motion, jerking of the body, and trembling of hands while writing .Also used to treat Echolalia, where the child repeats everything said to him. Also used to treat spasmodic twitching of the face, rolling of the head, and grinding of teeth.
5. Argentum Nitricum
Useful where the tics are typically worse when a person experiences anxiety. The medicine eases anxiousness and nervousness in kids and is helpful in cases where there is a loss of voluntary control of muscles, and trembling of body parts.There is trembling of hands that makes writing difficult, trembling of legs and balance issues, unsteady walking when unobserved and impulsiveness in children. Better work when there is an extreme desire for sweets may present.