TIC DISORDERS
Do you sense repetitive movements of muscles that often leave you
uncomfortable? Do you experience irregular, uncontrollable
movements of limbs and other parts of the body? The recurring
sensation of this kind of movement is referred to as Tics. These
movements are known as tics and can affect eyelids or face or occur
anywhere. In most cases, ticks are often harmless and temporary.
However, in some cases, tics can become hard to control. It can cause
that isn’t due to some underlying disease. Prominent examples include
transient tic disorders in childhood or family history of tic.
Tic Disorders can be managed with treatment and lifestyle changes.
TIC DISORDERS
Do you sense repetitive movements of muscles that often leave you uncomfortable? Do you experience irregular, uncontrollable movements of limbs and other parts of the body? The recurring sensation of this kind of movement is referred to as Tics. These movements are known as tics and can affect eyelids or face or occur anywhere. In most cases, ticks are often harmless and temporary. However, in some cases, tics can become hard to control. It can cause that isn’t due to some underlying disease. Prominent examples include transient tic disorders in childhood or family history of tic. Tic Disorders can be managed with treatment and lifestyle changes.
Symptoms of Tic
The symptoms of tic disorders can be referred to as Motor Tics and Vocal Tics.
Simple tics:
These are sudden and fleeting tics using few muscle groups. Examples include nose twitching, eye darting, or throat clearing.
Complex tics:
These involve coordinated movements using several muscle groups. Examples include hopping or stepping in a certain way, gesturing, or repeating words or phrases.
Movements of the limbs and other body parts are known as motor tics. Involuntary repetitive sounds, such as grunting, sniffing, or throat clearing, are called vocal tics. Tic disorders usually start in childhood, first presenting at approximately 5 years of age. In general, they are more common among males compared with females.
Treatment
Most tic disorders fade away with time. On the other hand, patients who experience significant distress due to their tics find that therapy, medication, or simple lifestyle changes can improve their condition significantly, especially with symptoms of Tourette Syndrome (a form of tic). Although tic disorders were once considered extremely rare, recent studies has shown that tic disorders affect as many as 20 percent of children and 1 percent of all adults. Despite these findings, no clear medical guidelines exist for how best to treat these conditions. Different doctors have their own preferred course of action for treating a patient’s tic disorder. Many doctors, however, take a “wait and see” approach to start with. Tics often operate in a cycle, waxing and waning on a two-week period basis. The majority of tics go away on their own after a few cycles, which meaning no treatment is needed. Even if the tic doesn’t go away without intervention, some patients still choose not to pursue any treatment. If the tics are not severe, or don’t cause intense embarrassment, most patients effected become used to tics and see treatment as unnecessary.
If treatment is determined to be necessary, by both the patient and the doctor, below options exist:
Medication :
At times, medication is prescribed to treat some tic disorders, but it’s not considered the first line of treatment. Generally, medication is only prescribed when tics interfere with functioning and when all non-medical interventions have been exhausted Although several medication options exist, it’s difficult to predict how a patient will respond to a specific mediation versus another. The first drug of choice is usually a haloperidol, a typical antipsychotic. Other options may include Risperidone, an atypical antipsychotic, and non-stimulant medications often used to treat ADHD including Strattera and guanfacine. Some patients also experience good results with medications such as SSRIs and tricyclics. All these medications should be started at the lowest possible dose to reduce possible side effects. Side effects vary for each medication, but generally include conditions such as weight gain, dizziness, problems sleeping, gastrointestinal distress, and headaches. In rare cases, the side effects can be more troubling than the tic disorder itself. In those cases, the patient is advised to seek other forms of treatment.
Therapy :
Habit-Reversal Therapy (HRT) is the therapy of choice for tic disorders. In HRT, the individual is taught to recognize the feelings that preceding the tics. In most cases, these can include a feeling of “tension” or “pressure” that can only be relieved by carrying out the tic. Once a patient successfully identifies the trigger, they can learn to respond by engaging in an alternative behavior; reducing the tension without resorting to the tic. Using HRT patients learn to identify stressors that can aggravate their tics, and offers them coping mechanisms or strategies to avoid those stressors entirely. HRT is shown to be highly effective, in both children and adults. Multiple studies have shown a 17 to 50 percent reduction in tics after approximately 6 weeks of therapy. It’s a common belief that patients who acknowledges and actively attempt to suppress their tic will experience stronger or more varied tics. However, countless studies have shown the opposite to be true. In fact, vocal and motor tics disorder showed that, even when treatment focused solely on vocal tics, motor tics still decreased by approximately 26 percent.
Nutritional Changes :
Research on the link between food and tic disorders is preliminary and very limited. Most doctors do not advise their patients to rely solely on food management to treat tic disorders. However, it has been shown that eating certain foods or avoiding others may have a positive effect on the tic conditions, with generally few or no side effects.
Omega-3 Fatty Acids :
In a small sample study, it has been shown that children and adults with tic disorders have experienced positive results while taking omega-3 fatty acids. One 2012 study published in Pediatrics found that, while consuming omega-3s did not significantly improve tic scores, it did help with “tic-related impairment” which are psychological distress or additional symptoms associated with the tic disorder. Additionally, it is shown that up to 50 percent of children with tic disorders also have ADHD, which also responds positively to omega-3s intake.
Magnesium and Vitamin B6 :
In another small 2008 study published in the journal Medicina Clinica, children with Tourette Syndrome (a form of tic disorder) experienced positive results while taking supplemental magnesium and vitamin B6. Although the results of the study are questionable due to its small sample size and lack of control group, introducing more food-sourced magnesium and B6 will not likely introduce any negative side effects, and could result in positive changes for children or adults with tic disorders. Foods’s high in vitamins include green leafy vegetables, legumes, whole grains, fruits, fish, and nuts contain magnesium and vitamin B6.
Avoiding Caffeine, Sugar, and Soda :
Another small study looked at the influence of certain category of foods on symptoms of tic disorders. Researchers found a statistically significant correlation between higher incidence of tics and increased consumption of cola drinks, coffee, black tea, preservatives, refined sugar, and artificial sweeteners possibly due to their effects on dopamine levels in the brain. These results are not a surprise, since most doctors already recommend that patients being treated for tic disorders avoid caffeine as much as possible. However, this particular study was the first to link preservatives, sugar, and other sweeteners to aggravated tics, suggesting that further research is needed to examine the corelations between these substances and tic disorders. Although special eating plans may not eliminate tics, but reducing stress including gastrointestinal stress can have an overall positive effect on the severity of the condition. If patients are sensitive to certain foods (like gluten, dairy, or food dyes), eliminating those may help to uncover the exact cause and indicate to patients to avoid them.
Treating Lifestyle Changes :
In certain mild cases, tic disorders can be treated with relaxation exercises that help children and adults reduce the stresses that can trigger of exacerbate tics. These include deep breathing, visual imagery, and guided muscle relaxation. While these techniques are not as effective as formal behavioral therapy, relaxation exercises can help patients improve their outlook and feel more in control of their tic’s symptoms. Exercise helps to relieve stress, provide an outlet for excess energy and help patients feel in control of their body and mind without negative side effects. The symptoms of tics are managed at Dr. Agahi's clinic, which offers a variety of therapy to assist people to manage their condition and enhance their lives. Dr. Agahi's therapy and psychosocial services encourage and assist clients in coping with stress, recognizing early warning signs of tics, and managing tics.