Nervous tics: types, symptoms, causes and treatments

These involuntary contractions of the muscles can become chronic problems.

All the people we have experienced throughout our lives situations in which, due to our level of stress or nervousness, a series of soft but usually quite annoying nervous tics have appeared. a series of soft but usually quite annoying nervous tics have appeared.

Although this is usually temporary and does not have to be linked to any medical condition, the nervous tics can become established in a chronic way; triggering symptoms of anguish and anxiety that tend to worsen them.

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What is a tic disorder?

By tics we understand all those involuntary involuntary corporal movements that appear like consequence of a nervous contraction. These movements can appear in multitude of groups of muscles that, in rest of occasions, the person does move to its will.

As a rule, the person can control more or less these tics, not without that this requires of a great effort on its part. Nevertheless, the most probable thing is that these appear repeatedly and in a more serious or intense way.

Also, as much the intensity as the frequency of the nervous tics will be much greater in in highly stressful situations.

Some of the involuntary movements traditionally associated with nervous tics are:

• Facial grimacing.
• Increase of the cadence of blinking.
• Fluttering of the nostrils.
• Lateral movements of the head.
• To stretch an arm repeatedly.
• Raising eyebrows.
• Biting the lips.
• Coughing or throat clearing continuously.
• Continuous repetition of a word.

Usually, these nervous tics occur for the first time in the infantile stage, mainly around the five years, being in addition more frequent in men than in women. In most cases the tics remain limited in time, attenuating and disappearing over a year or so. Nevertheless in some cases they can manage to become a chronic disorderespecially when these are associated with some type of disorder or physical alteration.

All those people who suffer some type of nervous tic usually report a high degree of anguish and irritation in relation to them, due to the fact that it tends to attract the attention of those around them and that it is not pleasant to experience sudden movements at the most inopportune moments. This anguish can derive in feelings of anxiety and stress which can get to worsen the situation even more, since to more anxiety more possibility there is of that appear the nervous tics.

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What types of tics exist?

There exists a small classification for the nervous ticswhich can be differentiated between phonic or vocal tics and motor tics. In addition, each one of these groups can be subclassified in simple or complex tics. Therefore, the grouping would be the following one.

1. Simple and complex motor tics

The nervous tics of simple motor category are those that occur with greater frequency in the general population. These use only a limited number of musclesas for example: movements of eyelids and eyebrows, hands or arms.

On the other hand, complex motor movements use and combine different groups of muscles, giving rise to jumps, blows, pirouettes or ecopraxias, in which the affected person makes involuntary imitations of the movements of another person.

2. Simple and complex phonic tics

As its own name indicates, the nervous tics, as much simple as complex, make reference to the involuntary and uncontrollable emission of sounds.. In the simple ones the person can make behaviors like snorting, throat clearing or nasal stridencies, whereas the complex ones consist of the automatic and uncontrolled repetition of words.

What happens with Tourette Syndrome?

Tourette Syndrome is considered to be the most complex neurological disorder in the world. the complex neurological disorder in which phonic nervous tics and motor nervous tics are combined.. For such tics to be considered symptomatic of Tourette Syndrome, they must have been present for more than one year, without a latency period of more than two months.

In addition, this condition usually appears in combination with other symptoms such as behaviors of an obsessive-compulsive nature and Attention Deficit Hyperactivity Disorder (ADHD).

The genetic cause of this syndrome has been determined, establishing the hypothesis that it is transmitted in an autosomal dominant manner. However, there are other genetic conditions that may be involved, such as genetic amplification, which refers to the gradual deterioration of the disease over generations.

Typically, this syndrome starts with symptoms of nervousness and restlessness that can be mistaken for ADHD, followed by motor symptoms such as facial twitching and small jerks. Finally, they appear the phonic tics which usually confirm the diagnosis of Tourette's Syndrome.

Causes and risk factors of nervous tics.

Except for the case of the Syndrome of Tourette, whose causes have been established as genetic, at the moment it has been impossible to determine the exact causes of the nervous tics. it has been impossible to determine the exact causes of nervous tics not associated with another condition.. As Huntington's chorea, which also presents tics and has a genetic origin.

Nevertheless, numerous lines of investigation point towards the possibility that the cerebral chemistry, specifically neurotransmitters like the dopamine, the serotonin or amino acids like the glutamate, possesses a fundamental paper in the appearance and development of these nervous tics.

On the other hand, there are some concrete cases in which yes the cause of the tic can be determined. These are:

• Side effects of surgery.
• Brain injuries.
• Poisoning by certain poisons.
• Cerebrovascular accidents.
• Brain infections.

As far as the risk factors are concerned, there are a series of situations that facilitate the appearance of nervous tics. Those are:

• Genetic factors: families with members who experience accesses of nervous tics.
• Sex: it has been observed that the incidence of appearance of tics is much higher in men than in women.

Is there a treatment?

As mentioned above, in the majority of the cases the nervous tics remit in an automatic way and without need of any type of treatment. Nevertheless, in those people in which the involuntary movements interfere in an important way in their day to day, very effective treatments exist at the time of attenuating or solving the problem.

The most appropriate type of treatment for the patient will depend on the type of tic, as well as its severity. However, there are three categories of treatment that are likely to be combined for greater treatment effectiveness. These include psychological therapy, medication or deep brain stimulation.

1. Psychological therapy

Using techniques such as Exposure and response prevention (ERP) or habit reversal therapypeople can identify when a tic is going to appear and prevent it or use movements that are incompatible with tics.

2. Pharmacological treatment

Well alone or as complement to the psychological intervention there exist certain quite useful medicines at the time of reducing the appearance of the tics. These medicines are:

• Muscle relaxants.
• Injections of botulinum toxin.
• Anticonvulsant drugs.
• Antidopaminergic medication.
• Drugs for associated symptomatology such as antidepressants or anxiolytics.

3. Deep brain stimulation

In those patients in which the previous treatments have not been effective and that the tics suppose a serious problem for the quality of life of this one, it is possible to resort to the deep brain stimulation. By means of this technique, a device is implanted in the brain of the patient that by means of electrical stimulation manages to reduce the intensity and appearance of the nervous tics.