Tics

"The study of the tics is relevant because it can be a banal and isolated symptom or be associated with other pathologies".

DR. ICIAR AVILES OLMOS
SPECIALIST. NEUROLOGY DEPARTMENT

The tics are defined as movements (motor tics) or sounds (vocal tics), brief, fast, repetitive, stereotyped, nonrhythmic and without objective. They affect mainly to the face, neck and shoulders.

Up to 21% of the children in school age have tics, being more frequent in the males. However, in most cases they are transitory.

Sometimes, tics are part of the so called Syndrome of Gilles de la Tourette. This neurological upheaval is characterized by the presence of motor and vocal tics, associated with upheavals of conduct.

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What are the symptoms of tics?

Motor tics can be simple or complex. The simple ones are limited to movements in which a concrete muscular group participates (ex blink, elevation of eyebrows or shoulders, cephalic turn.. ).  They can appear in several parts of the body, although they predominate in the face, neck and shoulders.  The complex motor tics are caused by the successive and continuous contraction of several different muscular groups giving rise to more complex movements like contractions of the abdomen or shakes and torsions of the neck and shoulders.

The vocal tics consist of emission of sounds, syllables or words of repetitive form, without a communicative aim and generally, they appear associated with motor tics. The most characteristic ones are carraspeo, shouts or other guttural sounds and air suction by the nose.

Often motor and vocal tics are preceded by sensitive tics consisting of unpleasant sensations such as itching, tingling or pressure.

The tics, unlike other disorders of the movement, can be inhibited during a brief period of time.

In general, they increase in intensity in situations of anxiety and fatigue and diminish when making other acts that require concentration (to read, to play a musical instrument). They usually appear during childhood and are often transitory. In the cases in which they persist, usually they are exacerbated in the adolescence and tend to improve or to stabilize in the adult age.

In the syndrome of Gilles de la Tourette, simple as much complex motor tics with vocal tics are combined that include ecolalia (to repeat what they hear), coprolalia (to say "tacos" or obscenities) or to make obscene gestures. Behavioral disorders can also appear, like the deficit of attention-hyperactivity and obsessive-compulsive disorder. 

Do you have any of these symptoms?

You may have tics

What are the causes of tics?

In most of the cases the cause of the tics is not known.

In the Syndrome of Gilles de la Tourette it is habitual to find a familiar aggregation, indicating a clear genetic tendency.

What is your prognosis?

The simple tics of beginning in the childhood generally are self-limited and they do not need treatment. When they persist, it is frequent that they have a fluctuating course, improving in periods of smaller emotional tension and in general, with the age.

If by its intensity, frequency or duration they interfere with the activity of the person, the beginning of pharmacological treatment is advised.

How are tics treated?

The objective of the treatment of the tics is the symptomatic control in those cases in which they generate functional problems. 

The pharmacological treatment of election of the tics is the neuroleptics and the catecholamines depleting drugs.

The treatment must be made of individualized way according to the gravity of the tics and of if it exists associated psychiatric upheaval.

In some tics the local infiltrations with botulinic toxin can be useful.

In the cases of complex tics refractory to the pharmacological treatment it can be made surgical treatment with deep cerebral stimulation.

The upheavals of conduct usually respond favorably to the antidepressants type inhibitors of the reuptake of serotonin, being advised to associate in addition cognitive behavioral therapy.

Where do we treat it?

IN NAVARRA AND MADRID

The Department of Neurology
of the Clínica Universidad de Navarra

The Neurology Department has extensive experience in the diagnosis and multidisciplinary treatment of neurological diseases.

We offer a diagnosis in less than 72 hours, along with a proposal for personalized treatment and post-consultation follow-up of the patient by our specialized nursing team.

We have the most advanced technology for an accurate diagnosis with cutting-edge equipment such as HIFU, deep brain stimulation devices, video EEG, PET and epilepsy surgery, among others.

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