Monday, August 15, 2011

Ask Us Anything: Why Do Children Develop Motor Tics?

"My eight year old daughter seems to have a motor tic. She jerks her head back, and she can't control the action. She doesn't jerk her head constantly throughout the day, but when she gets into a spurt, she'll do it every five seconds (and she has had at least one spurt every day since school ended). What could be the cause?"

Dr. Anthony Vetrano Responds:

Dr. Anthony VetranoMany children will have isolated tic disorder where tics occur during periods of emotional stress or pressure-filled situations (tests or performing in front of a crowd). Sometimes the stressors are not immediately obvious, so verbal investigation may be necessary.

At age 8, the stressor may be related to body image or self-esteem, as these are the two biggest emotional issues for all children in this age group.

A psychologist may be helpful in figuring out triggers and a plan. Medications are not usually helpful for benign tic disorders.

Motor tics may also be a sign of Tourette's Syndrome. Usually, this syndrome presents with some vocal tics as well (like throat clearing or swearing or jibberish). There may also be a component of OCD behaviors. OCD is Obsessive Compulsive Disorder; this includes being very rigid about where things are or how things are done. Tourettes can be helped by prescription medications which are relatively safe. Neurologists are often involved in the care of these patients; psychiatrists may be helpful as well.

Rarely, motor tics will be a sign of seizure disorders or other underlying neuro-muscular disease; so a visit to the neurologist may be helpful in shedding light on this subject.

Bill Hyland, MS, OT, Adds:

Bill Hyland, OTIf the tic is caused by a nervous reaction, this behavior can wax and wane depending on the presence and severity of the stimulus that is causing her to be nervous. Modifying her behavior and routine can be useful in reducing the motor tic.

Another likely cause of a tic in a healthy 8 year old would be that the reaction is behaviorial or attention seeking.

This behavior will be reinforced each time you comment on her having tic movements, thereby prolonging her episodes. This behavior is often eliminated or extinct on its own over time by ignoring it.

Two unlikely causes of a tic in a healthy 8 year old would be side effects from medication or a neurological disorder such as Tourette's Syndrome. If you suspect this, then she should be evaluated by a neurologist.

Also, if she has any developmental disorders such as cerebral palsy or epilepsy, this should be looked into as well.

About Our Experts

Dr. Vetrano

Anthony Vetrano, M.D. is chairman of Mercy Hospital’s Pediatrics Department and was named a Top Doctor in Western New York (2008-2010) in Buffalo Spree Magazine.

Bill Hyland

Bill Hyland is an Occupational Therapist at Partners In Rehab Sisters Hospital, which provides Physical Therapy, Occupational Therapy and Speech Therapy in Buffalo, NY.

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