It started as a small stretch of his mouth, which seemed to ease the discomfort of very chapped lips. It was soon accompanied by rapid eye blinking and eyebrow raising, involving my then-6-year-old son’s entire face.
The word “tic” came to mind, and I did what any curious/worried parent would do and turned to the Internet (which we know is generally a mistake when making a late-night, clearly non-professional medical diagnosis).
A tic is a spasm-like movement of particular muscles, especially of the face. Tics are sometimes referred to as “unvoluntary” movements, as opposed to “involuntary” movements. According to WebMD, that means “people are able to suppress the actions for a time. The suppression, though, results in discomfort that grows until it is relieved by performing the tic.” So it’s not that a person can’t control a tic (i.e., involuntary) – it’s just that it’s really uncomfortable to do so.
Transient tics are those lasting for at least a month but not more than a year. There is also chronic motor or vocal tic disorder, characterized by the presence of one or more long-lasting tics. Chronic tics may be either vocal or motor, but not both. A motor tic refers to movement of a discrete group of muscles. Also, symptoms must begin before a child is 18 years old to be considered chronic tic disorder.
In the extreme case – and the one that showed up as entry number five in more than 10 million results of a Google search for “involuntary tics in children” – is Tourette’s disorder.
Tourette’s disorder (also known as Tourette’s syndrome) is a hereditary brain disorder that causes people to do or say things they cannot control. It is characterized by repetitive motor and vocal tics, such as involuntary movements of the extremities, shoulders and face and, in some cases, saying inappropriate words. The exact cause of Tourette’s is unknown, but it has been linked to low birth weight, brain injury, and insufficient oxygen at birth. Tourette’s syndrome may also be more likely to occur in children whose mothers drank alcohol, smoked, drank caffeine or experienced extreme stress during pregnancy.
I have to admit I panicked slightly at the idea of Tourette’s. Although none of the factors were relevant (no known family history, no alcohol/smoking, etc., during pregnancy), it was hard not to let my mind wander. We’ve all heard stories about someone with Tourette’s blurting out curse words at an inappropriate time – I thought about how disruptive that could be to my son’s and his classmates’ education. Of course, no parent wants their child to be an easy target for teasing either.
But as I did more research, I was surprised at the prevalence of tic disorders – particularly in children. While people of all ages can exhibit tics, they are most common in children. Estimates vary on the number of school-age children who experience a tic at some time, ranging from 1 in 10 to as many as 25 percent. Tic disorders usually appear between the ages of 2 and 15 years and are far more likely to occur in boys than girls.
While no one knows exactly what causes tics to occur, “stress and sleep deprivation seems to play a role in both the occurrence and severity of motor tics,” according to WebMD. So telling someone who has a tic to stop doing it is like pouring oil on a fire – it just makes it worse.
The treatment for tic disorders depends on how severe the symptoms are. In many cases, the tic will resolve itself, which means most children outgrow their tics by the time they reach adulthood. In other cases, a doctor may prescribe behavioral therapy to help a person manage tic symptoms and reduce the occurrence of tics, or medication to reduce tic frequency – or they may prescribe a combination of the two.
In my son’s case, we weren’t going to get any answers in the days after his first tic appeared. A doctor friend told me no physician would even consider a Tourette’s diagnosis until the tic had been present for at least a year. The school nurse reassured us that more kids than we could imagine develop tics, and our son’s teacher said she would let us know if his behavior in the classroom changed.
And so we followed the advice of experts who say it’s generally better to ignore the tic – except at times when our son brought the subject up, when we simply reassured him that sometimes our muscles just do things, and that it would probably just go away eventually.
It’s been more than two years since that first tic occurrence. The tics diminished significantly within the first year, though he still occasionally exhibits what I think are more subtle tics, particularly when he is very excited or nervous – clenching of hands, blinking or clearing of his throat on a continual basis for a period of time.
The bottom line is that worrying about the situation didn’t change it, and in the long run, a diagnosis couldn’t change how much I love him.
WebMD: Tic Disorders and Twitches
The Merck Manual Home Health Handbook: Tics
Childbrain.com: Tic Disorders
Karen Nerney has been a communications specialist with the Capital Region BOCES Communications Service since 2011. Prior to that, she spent many years as a journalist in the Boston area. She is mom to two teen-age girls and an 8-year-old son. She has learned through experience to avoid making non-professional medical diagnoses late at night.