Nervous tics or, as they are commonly called in medicine, tic disorders are common. Transient tics occur in 10–24% of children, and chronic ones in 1.6%. Moreover, they can be either independent or part of the structure of other disorders.
Tics are stereotyped, repetitive movements. They usually first appear in children aged 3 to 5 years. Tics are characterized by a wave-like course: periods of exacerbations, which usually last about 1.5 months, are replaced by periods of remission.
What are the reasons?
Various stress factors (for example, fear) play a certain role in the occurrence of tics. At the same time, positive and negative experiences can lead to increased tics. Although there are other reasons (for example, Gilles de la Tourette's syndrome is genetically determined).
Parents often associate the appearance of childhood tics with stress and emotional turmoil. In fact, tics are caused by changes in metabolism (dopamine and norepinephrine) in the subcortical structures of the brain. A person is born with similar predispositions and is often inherited.
Tics are not always stressful. There is not always a connection between the occurrence of tics and the experience of stress. A child can grow up in a prosperous and happy family, but one day, without external reasons, due to the peculiarities of brain development, a mechanism turns on and clinical symptoms appear.
Main manifestations
Localization of tic movements most often occurs in the facial or neck muscles. Over time, they can spread from top to bottom. The most common examples of simple childhood motor tics are:
- frowning;
- blinking;
- squinting;
- moving the wings of the nose;
- drawing in air through the nose;
- twitching of the corner of the mouth;
- turning or tilting the head;
- shrug;
- flinching;
- twitching of limbs;
- flexion or extension of fingers;
- snapping fingers.
Vocal tics are manifested by coughing, throat sounds, sniffling, spoken syllables or exclamations. This is a meaningless sound that interferes with speech and gives the impression of stuttering or stuttering. If no measures are taken to eliminate them, the situation will only get worse. Tic movements also progress and reach a new level in the form of:
- grimace;
- head tossing;
- touching various parts of the body with hands;
- contractions of the abdominal muscles or diaphragm;
- squats;
- bouncing.
All of the above nervous tics in children are not all manifestations of the disease. They can be individual and atypical. It all depends on the child’s level of development, his character and temperament, sensitivity to environmental stimuli and a number of other reasons.
How is this treated?
Treatment of tics is carried out on an outpatient basis, and it should combine not only drug treatment (depending on the severity of symptoms and many other factors), but also:
- Psychotherapy including family, behavioral and play therapy.
- Psychosocial therapy. Which includes: correct understanding of symptoms, taking into account the child’s needs and much more. Moreover, it is indicated even with harmonious relationships in the family.
- Therapeutic and pedagogical influence.
Which, in an integrated approach to treatment, gives a good prognosis in 60–70% of patients.
Classification of tic disorders
Classification of tic disorders can be carried out on several most significant grounds.
According to etiology (origin of the disease), tics are divided into:
- Primary – occur in the absence of any other disorder, are the only symptom of the disease and are often associated with the child’s hereditary predisposition.
- Secondary – occurs against the background of another disease.
According to clinical manifestations, tics are:
- Motor (motor) - are divided into simple (for example, blinking, opening the mouth), and complex, occurring in the form of entire coordinated movements (for example, jumping).
- Vocal (vocal, sound) - also divided into simple, manifested in the form of individual sounds (sniffling, coughing, snorting, squeaking), and complex, representing words or phrases of a socially unacceptable nature (coprolalia), repetition of words and statements of another person (echolalia ), or your own words and phrases (palilalia).
- Sensory – represent repeated sensory sensations (cold, pressure, burning) in the same part of the body.
- Ritual - manifested in the form of repeated complex actions such as walking in a circle.
Based on their duration, the following types of tics are distinguished:
- Transient - occur daily in a child for at least 1 month, but persist for no more than 1 year.
- Chronic – occur almost daily or intermittently in a child for more than 1 year.
And finally, according to the degree of severity, tics are divided into:
- Local – occurs with the involvement of one muscle or one group of muscles.
- Multiple – occur with the simultaneous involvement of several muscle groups.
- Generalized , or Tourette's syndrome, is a hereditary disease that involves a combination of multiple motor and vocal tics with the gradual involvement of coprolalia (repeated shouting of socially unacceptable words or phrases).
Nervous tics in children: where to turn for help?
If you notice a nervous tic in your child, you should consult a specialist. The First Children's Medical Center offers assistance from qualified child psychiatrists.
Child psychiatrists at the First Children's Medical Center are ready to help the family at any moment and in the most difficult situation. Contact professionals to maintain your child’s mental health!
You can make an appointment with a child psychiatrist in Saratov from 8.00 to 20.00 by calling (8452) 244-000. Reception is by appointment only.
General concept of ticks
This is the most popular pathology of the children's nervous system at an early age. It is simply impossible not to visually notice the manifestation of a tic, although some parents manage to go for weeks or even months without seeing any oddities in their child’s behavior.
Tics are involuntary, stereotypically repetitive, sudden or jerky movements that are the result of spontaneous contraction of individual muscles or groups of muscles.
At the initial stage of development of the disorder, attacks occur quite rarely, and repetitive movements do not cause much concern or problems. The child can even restrain or control them. However, attempts to control the tic cause him:
- internal discomfort;
- feeling of anxiety;
- mental stress.
When control over oneself weakens, tic manifestations occur, and the baby immediately receives obvious relief.
Nervous tics in children are usually detected between the ages of two and fifteen years. In the period of 6–8 years, tic hyperkinesis most often develops, while at 14–15, in approximately half of the cases it disappears spontaneously.
Fun fact: Boys are five times more likely to have the disorder than girls. From a scientific point of view, this is explained by the more stable psyche of female representatives.
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Increased fatigue. The child gets tired quickly
In most cases, increased fatigue and exhaustion of the child’s nervous system has very specific causes and is quite easy to correct or treat.
It is very important to understand and find the reasons why fatigue occurs. Treatment must precisely target the cause of the problem. Unfortunately, we often see the opposite examples. For example, a child gets tired due to a chronic infection, and he is taken to a psychologist and “behavior is corrected,” or, for example, the cause of fatigue is related to hormonal levels, and he is sent to a psychiatrist and prescribed medications that are unnecessary in this case. The opposite situation is possible: the child does not have any special health problems, but only psychological problems that lead to fatigue. It is necessary to clearly understand the reason for what is happening, and only then the treatment will bring the desired result.
A child's abrupt switching from active and dynamic games to complete loss of strength, in which the child can fall asleep in one minute, is the norm for children from two to five years old.
At this age it will be absolutely normal fatigue followed by a transition to activity.
Increased fatigue should alert you if:
- The child is so tired that he cannot concentrate, lags behind his peers in learning and mastering new skills;
- The child cannot sleep or wakes up at night, feels drowsy during the day;
- In the morning the child wakes up tired, has difficulty turning on, refuses breakfast;
- The child often suffers from colds;
- You notice a prolonged (more than 2 weeks) general lethargy in the child, dark circles under the eyes and pallor, a decline in mood;
- The child is in a negative mood most of the time, gets offended and cries for no objective reason;
- Drowsiness, apathy and indifference to previously favorite activities appear;
- The child complains of headache or dizziness;
- The child loses motor dexterity, shows aggression, and often changes positions when reading or doing homework;
- The child complains of fatigue and/or pain in the legs.
Increased fatigue is mainly due to the fact that the child's nervous system cannot maintain arousal long enough to support everyday tasks, including learning, mastering skills, speech, and so on.
A tired child finds it difficult to maintain attention on one thing, it begins to dissipate, as a result of which the child resists learning, which turns out to be too difficult for him. The situation develops into conflicts, and the reason for this is increased fatigue.
- Exhaustion of the child’s nervous system due to prolonged stress,
i.e. “getting stuck” of the body in a state of preparation for responding to danger. The stress response is designed by nature to be short-term; it comes to quick realization and a way out of stress. But if suddenly the stress readiness in the child’s body becomes long-term, the nervous system is gradually depleted. Thus, brain exhaustion occurs and, as a result, rapid fatigue. - Sleep disturbance .
Normal healthy sleep consists of four stages, of which the deepest and most important are the 3rd and 4th. With a deficiency of deep stages of sleep, nervous exhaustion occurs quite quickly. Frequent variants of sleep deprivation in children: the child has a normal sleep duration, but sleeps superficially, the child sleeps with awakenings, the child has shortened sleep (falls asleep for a long time or wakes up too early). Some sleep problems can be clarified by performing overnight EEG monitoring. - The presence of increased intracranial pressure
, when the brain is pressured by an excessive amount of cerebrospinal fluid and cannot remain in a state of excitement for a long time. - Chronic diseases,
and very often these are metabolic disorders, infections (adenoids, chronic tonsillitis), decreased thyroid function or other endocrine imbalance. Chronic infections can be associated with the herpes virus, streptococci, which very often cause such chronic fatigue. In this case, we will suggest that you put the child’s immunity in order, treat infections, and then the health of the child’s nervous system will be restored.
