Tic Disorders

Tic disorder is a neurological disorder characterized by repetitive, involuntary, and sudden muscle contractions or vocal sounds such as motor or vocal tics. Tics can usually increase in situations such as stress or excitement and can be temporarily controlled, but sometimes they may become chronic. Tics occur due to biological factors; environmental conditions can affect their form and severity. They are not learned movements or under the person’s control. Many individuals report feeling a sensation that precedes a tic attack and serves as a harbinger of the tic. Tourette Disorder (Syndrome) is a neurodevelopmental disorder that involves both motor and vocal tics and usually begins in childhood. Complex tics, mental tics, and sensory phenomena accompany it more frequently than other types of tics. Simple tics are rapid, sudden movements or single meaningless sounds that generally last less than 1 second, are continuous, purposeless, and usually involve one or a few muscle groups. Complex tics, on the other hand, are movements that last longer or sounds that appear in the form of words. The prevalence of Tic Disorders is reported as 3%. Tics most commonly begin between the ages of 3-8. During this period, simple motor tics such as eye blinking and shoulder shrugging are usually observed. A few years after motor tics, simple vocal tics such as throat clearing may be seen.

Tics tend to wax and wane from time to time. Season, stressful situations, comorbid illnesses, anxiety, fatigue, and social factors can cause an increase in tics. When tics occur, warning the child or telling them not to do it will most often increase the tics or, at best, will not work. Simple tics mostly tend to decrease and disappear toward the end of adolescence. In Tourette syndrome, however, tics may begin at younger ages and have a higher likelihood of continuing into adulthood. The disorders most frequently accompanying tics are Attention Deficit Hyperactivity Disorder, Obsessive-Compulsive Disorder, and Specific Learning Disorder. All these comorbid diagnoses should be taken into consideration during evaluation. Tics are sudden and involuntary movements. It may be possible to suppress them for a certain period. As the child’s age increases, their control over the tics also increases. Because children do not perform their tics at school but do so at home, parents may sometimes perceive this as “trying to get attention.” They mostly try to delay them because they are afraid of the reactions they will receive in their friend environment. This can cause the tics to appear intensely when they get home. Warning increases stress and thereby causes the tics to increase. If the tics are mild and do not affect daily life, there is no need for intervention.

In psychoeducation, information should be given about the nature and course of the disorder, treatment alternatives, suppressibility, and delayability. They should be informed that sleep hygiene, general health status, and emotional state can affect the course of the disorder. In severe cases, antipsychotic group medications such as aripiprazole and risperidone, and alpha-agonist group medications can be used in medical treatment.