Definition of Facial tics:

A facial tic is a repeated spasm, often involving the eyes and muscles of the face.

Causes, incidence, and risk factors:

Tics most often occur in children, but may last into adulthood in some cases. Tics occur three to four times as often in boys as girls. Tics may affect as many as one-fourth of all children at some time.

The cause of tics is unknown, but stress appears to make tics more severe.

Short-lived tics (transient tic disorder) are common in childhood.

Certain medications, such as methylphenidate (used to treat hyperactivity in children), were once thought to cause tics in children who are already likely to get the disorder. However, recent studies do not support this idea, and suggest that these medications can be used in children with tics who also have attention-deficit disorder (which often occurs in the same group of children).

A chronic motor tic disorder also exists. It may last for years. This form is very rare compared to the common short-lived childhood tic. Gilles de la Tourette syndrome is a separate condition in which tics are a major symptom.

Symptoms:

• Repeated, uncontrolled spasm-like muscle movements, such as:
  • Eye blinking
  • Grimacing
  • Mouth twitching
  • Nose wrinkling
  • Squinting
• Repeated throat clearing or grunting

Signs and tests:

The health care provider will usually diagnose a tic during a physical examination. No special tests are needed. In rare cases an EEG may be done to look for seizures, which can be the source of tics.

Treatment:

Short-lived childhood tics are not treated. Calling the child's attention to a tic may make it worse or cause it to continue. A non-stressful environment can make tics occur less often, and help them go away more quickly. Stress reduction programs may also be helpful.

If tics severely affect a person's life, medications such as clonidine or risperdal (Risperidone) may help control them.

Expectations (prognosis):

Simple childhood tics should go away on their own over a period of months. Chronic tics may continue for a longer period of time.

Complications:

In most cases, there are no complications.

Calling your health care provider:

Call for an appointment with your health care provider if tics:

• Affect many muscle groups
• Are persistent
• Are severe

Prevention:

Many cases cannot be prevented. Reducing stress may be helpful. Sometimes counseling can help your child learn how to cope with stress.