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Nervous tics and twitches are persistent involuntary movements that can present themselves in any part of the body. Generally speaking, these are linked to the motor system as is the case of eye twitching or vocal tics (the repetition of sounds, words, etc.).
In this article, we're going to take a closer look at what nervous tics are and how they affect both children and adults. Plus, we discuss the main types. Finally, we'll tell you about chronic motor tic disorder, transient tic disorder, and Tourette's syndrome and how to treat these since tics and twitches are symptoms of all of these conditions.
Nervous tics are non-voluntary body movements or vocal sounds that repeatedly occur quickly and suddenly. These are stereotypic movements. However, they aren't rhythmic.
To that effect, it's important to differentiate between nervous tics and other behaviors known as nervous habits -activities that reduce anxiety and increase focus, for example, fingernail biting.
Unlike in the latter case, an individual with nervous tics feels an unrelenting urge to follow through with a certain behavior, and it might seem uncontrollable. In some cases, the person can suppress the movement or noise if they are aware of their actions.
Depending on where the tics present themselves, they are either classified as 'motor' or 'vocal,' and their etiology and frequency determines whether they are of a simple or complex nature. The cause of these varies, however, periods of high stress or anxiety and organic pathologies (congenital or acquired) are a few main reasons that tics appear.
Besides, nervous tics are a type of dyskinesia, a medical term used to describe the alteration or distortion of movements that seem voluntary, but that the individual really has no control over.
Although the severity of tics and how long they last varies considerably, in many cases, they are connected to neuropsychiatric disorders that children, adolescents, and adults can all have.
In any case, nervous tics most frequently affect the face, neck, voice and the upper torso. However, it is possible for them to appear in any area of the body. Having a tic is very hard to describe to people who have never had one themselves.
This is because having a nervous tic is like having to cough because you have a scratchy throat or because something's tickling your nose. This is an involuntary and uncontrollable feeling, and an immediate response comes along with it.
As we mentioned, there are different types of nervous tics. Some of these are transient and could indicate high levels of anxiety.
In other cases, eye twitching can also indicate hyperactivity or overstimulation whether this is due to high energy levels, stress, or even the effects of some kind of substance, for example.
The specific cause of the eye twitching may vary depending on the individual's age, state of health, daily activities, the pressure that they're under, etc., and a specialist should always be the one to evaluate this.
Likewise, the frequency with which this involuntary eyelid movement occurs and the amount of discomfort that it inflicts could also help to determine the cause of this tic.
Eye twitching is a factor listed on some psychological evaluation scales for anxiety and hyperactivity, neither of which are directly related to nervous tics (as we'll see later on).
Psychopathology initially differentiates between 2 main types of nervous tics depending on how much discomfort they cause the person. The two categories are: simple tics and complex tics. Below, we take a look at the characteristics of both kinds.
Simple tics involve the movement of very few muscles and making sounds; these last for just a few seconds. Some examples of simple motor or vocal tics include facial grimacing, eye blinking, neck jerking, grunting, sniffing, or constant throat clearing, etc.
On the other hand, complex tics involve many muscles, and in their vocal form, an individual might say full words or entire sentences, which is why they last much longer than simple tics. Some complex motor tics include gestures like jumping, squatting, hand motions, and touching or smelling an object repeatedly, among other things.
Additionally, complex vocal tics include palilalia (repeating one's own speech); coprolalia (the utterance of obscene words); and echolalia (repeating someone else's speech).
There are different types of conditions related to nervous tics, and these are the three criteria that you can use to differentiate between them:
The age of the individual when the nervous tic appeared
The duration of the disorder
The amount and types of tics
Below, we specify the 3 most common disorders involving nervous tics: transient tic disorder, chronic motor or vocal tic disorder, and Tourette's syndrome.
The defining characteristic of transient tic disorder is that it most often appears before the individual's 18th birthday. These nervous tics usually happen every day for at least 4 weeks, but only for a period of 1 year or less.
In addition to this, a child or adolescent diagnosed with this disorder can't meet the criteria for Tourette's syndrome or chronic motor tic disorder.
The tics seen in this disorder can either be motor or vocal, but not both. In this case, to be diagnosed with this syndrome, the individual has to be under 18 years of age.
In this case, these tics need to occur several times a day, almost every day or intermittently for a period of more than 1 year. Finally, for diagnosis, the child cannot present symptoms of Tourette's syndrome.
Tourette's syndrome is the most serious of the 3 tic disorders that we've mentioned. As with the prior, the individual needs to be under 18 for diagnosis. In this case, multiple vocal and motor tics need to be present, although not necessarily simultaneously.
Plus, these symptoms must appear several times throughout the course of the day, almost every day or off and on, for a period of more than a year.
In diagnosing Tourette's syndrome, there are also variations regarding the location, severity, complexity, frequency, and number of tics present over a period of time; and finally, these nervous tics can't be the result of any substance (like stimulants) or a central nervous system disease.
As we said, nervous tics happen for many different reasons. Therefore, there are various options to stop them (if this is possible) depending on whether the movements are sporadic, or if they are the consequence of any of the disorders that we mentioned previously.
In the first case, this is probably an involuntary reflex that happens when the individual is experiencing stress. So, the best way to get rid of tics, in this case, is through relaxation and coming up with better stress management strategies.
If the tic continues, after trying these methods it might be time to reevaluate the situation since this means that there could be another underlying cause. On the other hand, for those with any of the three tic disorders we mentioned before, applying a holistic, multidisciplinary approach that allows for a comprehensive treatment plan is one of the best options.
This means that the treatment plan should include everything from psychoeducation and appropriate evaluation to psychotherapy, and possibly pharmacological intervention if necessary.
In this case, the patient and his or her family should receive psychoeducation. This consists of providing accurate information regarding the course and progression of the affected person's condition. Naturally, for this to happen, previous diagnostic testing and appropriate evaluation are necessary.
The individual's educational services should also be involved in this process, (if the affected person is a child or an adolescent) assisting in the adaptation of his or her learning environment, setting the child up for academic success.
On the same note, everyone in the child's educational environment should receive psychoeducation -both teachers and students. It's important to see the bigger picture by focusing on the individual's abilities and autonomy and not just the nervous tics. This helps to keep the child or adolescent from being singled out or bullied.
Cognitive-behavioral therapy is the most appropriate treatment for those with nervous tics since this type of psychologist can help the individual to manage the frequency of their tics and the psychological repercussions that these have on the person.
Interventions to back up psychotherapy sessions that involve coming up with strategies to handle emotions, especially when the tic is stress-related, or linked to nervousness or anxiety, could be very helpful.
On the other hand, speech therapy could also be the key, especially when the involuntary movements are of a vocal nature involving language and communication.
Finally, as a last resort, the use of medication to treat the nervous tics can be taken into consideration, especially when the cause isn't psychogenic, but instead a pathology's way of manifesting itself.
These types of interventions involving medications are mainly used to help control motor and vocal tics although the long-term side-effects should be taken into account, especially in the case of children and adolescents.
The psychotropic drugs prescribed are typical neuroleptic medications (antipsychotics), like haloperidol (Haldol) and pimozide (Orap); atypical antipsychotics like risperidone (Risperdal) and clozapine (Clozaril) and sometimes benzodiazepines to reduce the patient's anxiety, among other things.
Check out the original article: ¿Qué son los tics nerviosos? Tipos, causas y cómo eliminarlos at viviendolasalud.com
Frey, R. (2006). Tics. In K. Krapp & J. Wilson (Eds.), The Gale Encyclopedia of Children's Health: Infancy through Adolescence (Vol. 4, pp. 1836-1843). Detroit: Gale.
Scherstuhl, H. (2003). Tic disorders. In M. Harris & E. Thackerey (Eds.), The Gale Encyclopedia of Mental Disorders (Vol. 2, pp. 982-988). Detroit: Gale.