Chronic motor tic disorder

Definition

Tics are repeated, uncontrollable bursts of activity or speech. Chronic motor tic disorder involves rapid, recurrent, uncontrollable movements or vocal outbursts (but not both).

Causes, incidence, and risk factors

About 1 to 2% of the population has chronic motor tic disorder. The condition is more common than Tourette's Syndrome, but not as common as transient tic disorder, which occurs and then stops without treatment within a year.

It is thought that all types of chronic tics are types of Tourette's Syndrome.

Symptoms

• Vocalizations (grunts, throat clearing, abdominal or diaphragmatic contractions)
• Facial grimacing
• Excessive blinking
• Rapid, recurrent movement of the arms, legs, or other areas

A person can suppress (hold off) these symptoms for a small length of time. A sensation of relief is experienced when these movements have been carried out. Tics may persist during all stages of sleep, and may get worse with stress, heat, excitement, and fatigue.

Signs and tests

A tic can usually be diagnosed during a physical examination. Tests are generally not necessary.

To be diagnosed with the disorder:

• The person must have had the tics nearly every day for more than a year
• The person has not had a tic-free period longer than 3 months

Treatment

Treatment depends on how bad the tics are and how the condition affects a person. Medicines and psychotherapy are used only when the tics have a substantial impact on daily activities, such as school and job performance.

Drugs used to treat tics include dopamine blockers, such as pimozide and risperidone. However, they are not always successful and can cause side effects.

Expectations (prognosis)

Children who develop this disorder between ages 6 and 8 do very well. Symptoms may last 4 to 6 years, and then stop without treatment in early adolescence.

When the disorder begins in older children and continues into the 20s, it may become a life-long condition.

Complications

There are usually no complications.

Calling your health care provider

There is usually no need to see the health care provider for a tic unless it is severe or becomes disruptive to the person's life.

If you can not tell if the movements are a tic or something more serious (such as a seizure), consult with your health care provider.

Illustrations

Central nervous system

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Chronic vocal tic disorder; Tic - chronic motor tic disorder ; chronic motor tic disorder