THE MERCK MANUAL HOME HEALTH HANDBOOK
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Tic Disorders

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Tics are rapid, repeated involuntary movements that are fundamentally purposeless.

One in four children may have a tic of some sort during a few months of their childhood. Such tics are much more likely to occur in boys than in girls. Common tics include repeated coughs or throat clearing, blinking or grimacing, shoulder shrugging, lip smacking, and various hand gestures. Stress and fatigue can make tics worse. Usually, tics occur only when children are awake. They can be voluntarily controlled for short periods of time but only with conscious effort.

Tics sometimes occur with other disorders such as obsessive-compulsive disorder or result from certain infections or certain drugs, especially drugs used to treat attention-deficit/hyperactivity disorder (ADHD), such as methylphenidate or amphetamine.

Eventually, most tics disappear without treatment. However, in fewer than 1% of children, tics persist. If they persist and cause problems (such as embarrassment), a tic disorder may be diagnosed. If the tics are all vocal (such as throat clearing), vocal tic disorder may be diagnosed. If the tics are all movements (such as eye blinking), motor tic disorder may be diagnosed. If children have a combination of vocal tics and tics involving movement, Tourette's syndrome may be diagnosed (see Movement Disorders: Tics).

In many cases, no treatment is needed other than reassurance. If tics persist and are bothersome, drugs may be used. Usually, antipsychotic drugs (such as haloperidol or risperidone) are very effective in controlling tics.

Last full review/revision February 2009 by Hugh F. Johnston, MD

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