Nervous tics in children: why they occur and how to help

In early childhood, neuropsychiatric disorders such as tics are quite common.
The scientific name is tic hyperkinesis. Parents immediately notice changes in the baby’s behavior. Uncontrolled movements of certain parts of the body or certain muscles in a child cannot but become a cause for concern and questions arise:

• Where did the disease come from?
• Could it have been prevented?
• What to do?
• How to treat?

This list can go on for a long time. One thing is clear - there is certainly cause for concern. And the first thing you need to do is find out as much information as possible about this neurological disorder.

So what are nervous tics in children and what is their danger?

General concept of ticks

This is the most popular pathology of the children's nervous system at an early age. It is simply impossible not to visually notice the manifestation of a tic, although some parents manage to go for weeks or even months without seeing any oddities in their child’s behavior.

Tics are involuntary, stereotypically repetitive, sudden or jerky movements that are the result of spontaneous contraction of individual muscles or groups of muscles.

At the initial stage of development of the disorder, attacks occur quite rarely, and repetitive movements do not cause much concern or problems. The child can even restrain or control them. However, attempts to control the tic cause him:

• internal discomfort;
• feeling of anxiety;
• mental stress.

When control over oneself weakens, tic manifestations occur, and the baby immediately receives obvious relief.

Nervous tics in children are usually detected between the ages of two and fifteen years. In the period of 6–8 years, tic hyperkinesis most often develops, while at 14–15, in approximately half of the cases it disappears spontaneously.

Fun fact: Boys are five times more likely to have the disorder than girls. From a scientific point of view, this is explained by the more stable psyche of female representatives.

TIKS ARE MYSTERIOUS THINGS!

Children often blink their eyes. Girls are little coquettes when they are being teased, boys are hooligans when they tease someone. And it always looks pretty funny. But there are situations when a child’s frequent blinking is not a game, but a reaction of the nervous system. And this is already a signal that the child needs help. What needs to be done if your child has tics, we’ll talk about this with Candidate of Medical Sciences, doctor of the highest category, pediatric neurologist Sergei Vladimirovich Zaitsev

Sergei Vladimirovich, many mothers understand tics as blinking of the eyes. But this is just an iceberg...

Absolutely right. And it seems to me that this perception of tics is due to the fact that the condition when a child “for no reason starts blinking his eyes,” as mothers say, is the most common. So let's first figure out what tics are. Tics are involuntary, that is, occurring against the will of a person (child), stereotypically repeated, short contractions of individual muscles or groups of muscles. External manifestations are usually monotonous, that is, the same muscles contract. Most often, tics occur in the muscles of the face, neck... It is impossible not to notice them. With facial muscle tics, the child suddenly wrinkles his forehead, frowns, closes his eyes, moves his nose, purses his lips, and contractions can involve half or all of the facial muscles. If a child has tics in the muscles of the neck, then he periodically turns his head as if his collar is too tight, or moves his shoulders, as if adjusting clothes that fit awkwardly. In any case, the mother should pay attention if such moments appear in the child’s behavior.

You mentioned that when mothers come to see you, they often use the expression “The child started blinking for no reason.” But every problem has “its own root of evil.” Why can a child develop tics?

Tics really never happen out of the blue, as mothers sometimes think. Children are very sensitive to problems in the family, even those that, from the parents’ point of view, do not concern them. It happens that a child has some kind of trouble at school in the yard and this leads to excessive internal worries. Thus, a child’s grief, which seems insignificant to adults, can, under a certain set of circumstances, lead to a nervous breakdown.

One can also note the hereditary factor in the occurrence of tics, while genes can “sleep” for several generations. That is, if your child developed tics, then it may well be that your grandfather suffered from them, and maybe you yourself once had them.

It is worth noting that tics can also occur against the background of a head injury or neuroinfection, as well as when using certain medications, such as antipsychotics or psychostimulants - but this is a separate conversation. Often, the causes of tics must be sought in the child’s internal discomfort, which is formed from the problems surrounding him.

I know that tics are usually classified as so-called “borderline conditions” - a term not only neurological, but also psychiatric. So which specialist should a mother contact if her child develops tics?

The problem of tics really lies on the border of several specialties: neurology, psychology and psychiatry. Usually a standard set of examinations is used: the child is prescribed an EEG (electroencephalogram), this is necessary in order to make sure that the child does not have a physiological basis for the occurrence of tics and that he primarily needs psychotherapeutic help. Then a consultation with a child psychologist is scheduled, and finally, a neurologist determines an observation and treatment plan.

There is an opinion that by adolescence, tics can go away on their own. Hence the question: should they always be treated?

Tics are all different and the range of their manifestations is huge: from quickly passing obsessive blinking, which some parents may not notice, to chronic widespread motor and vocal tics with mental disorders (for example, Tourette's disease).

If your baby has developed tics and you have consulted a doctor, then at the beginning of the illness even an experienced specialist is sometimes unable to accurately predict the further course of events. Therefore, it is necessary to monitor the child’s condition. And if tics prevent him from living fully, from communicating normally, they weigh him down, then, of course, it would be worth trying to get rid of them.

Although sometimes tics can indeed disappear on their own, this really depends on many factors. The main thing in the strategy of getting rid of tics is to eliminate the cause of their occurrence, that is, what led to their appearance: problems in the family, misunderstanding on the part of parents, some internal difficulties of the child, etc. Mom should make every effort to establish the true background of the current situation and try to get rid of it. There will be no reason, and the tics will disappear as a consequence.

That is, the mother must first of all figure out in a human way what is happening to the child. Where then do some mothers get such a medically business-like approach to treating tics?

Partly from the insufficiently competent doctors who advised her about tics, partly from their own desire to treat. Yes, yes, and don't smile. Just before you, I had an appointment with a boy and his mother about tics. The first thing I asked my mother was: “Is everything okay in the family, in the relationship with the child? ", "of course" - as my mother reported. But during the visit, she pulled the child down twenty times, didn’t say hello right away, said the wrong thing, sat down wrong, looked in the wrong direction. I myself would start to develop tics if I was pestered like this for 24 hours. I tried to explain to her that it would be worth starting by reconsidering the relationship with the child. She was offended and said that she had come so that the child could be prescribed an effective drug for tics, and not taught how to live. She also promised to write a complaint (laughs). It is the belief that a pill can solve any problem that often prevents people from coping with this problem.

How today neurologists help mothers cope with childhood tics...

Firstly, this is, of course, psychological and pedagogical correction; a child psychologist can help with this. Secondly, the mother should adjust the child’s lifestyle. Introduce a diet; he should not be given foods containing caffeine: tea, coffee, cola, chocolate. It wouldn’t be a bad idea to enroll your child in a sports section or just let him start devoting more time to sports activities, but it’s better to limit his time watching TV and endless games on the computer. If necessary, drug treatment is carried out in courses 3-4 times a year.

What would you recommend as a “prevention” for tics?

Preventing tics is not difficult at all. Parents just need to try to build a trusting relationship with their child. Let the family have a psychologically comfortable and calm environment. In relation to your child, follow the principle of less pressure - more understanding. In a word, a mentally and physically healthy lifestyle will help the child in the future avoid the occurrence of such not very pleasant phenomena as tics.

Irina Kovalkova, Stork magazine

See also:

• Duplex scanning MAG
• Neurologist for infants
• Consultation with an orthopedist

Types of nervous tics in children

Each child has his own individuality, and therefore nervous tics that arise for one reason or another are different.

Tic manifestations generally have two types:

1. Motor (motor). They are detected by spasms of individual muscles, their groups or movement of limbs and other parts of the body.
2. Voice (vocal). They can be recognized in the form of frequently repeated individual sounds, syllables, exclamations, words and even phrases.

Both groups are divided into simple and complex tics. Everything is clear here. A simple form - one short movement or sound, a complex one - several muscle groups are involved, if there are vocal disorders, progress is also observed in them.

Main manifestations

Localization of tic movements most often occurs in the facial or neck muscles. Over time, they can spread from top to bottom. The most common examples of simple childhood motor tics are:

• frowning;
• blinking;
• squinting;
• moving the wings of the nose;
• drawing in air through the nose;
• twitching of the corner of the mouth;
• turning or tilting the head;
• shrug;
• flinching;
• twitching of limbs;
• flexion or extension of fingers;
• snapping fingers.

Vocal tics are manifested by coughing, throat sounds, sniffling, spoken syllables or exclamations. This is a meaningless sound that interferes with speech and gives the impression of stuttering or stuttering. If no measures are taken to eliminate them, the situation will only get worse. Tic movements also progress and reach a new level in the form of:

• grimace;
• head tossing;
• touching various parts of the body with hands;
• contractions of the abdominal muscles or diaphragm;
• squats;
• bouncing.

All of the above nervous tics in children are not all manifestations of the disease. They can be individual and atypical. It all depends on the child’s level of development, his character and temperament, sensitivity to environmental stimuli and a number of other reasons.

Symptoms of a nervous tic

A general pattern in the external manifestation of tics is a decrease in the frequency of their appearance in the direction from the head to the lower extremities. In most cases, children develop a blinking tic, followed in descending order of frequency by facial tics, movements of the head, neck, body and limbs, and vocal tics. In general, the most common symptoms of tic disorder :

• Frequent blinking of one or both eyes;
• Raising eyebrows;
• Wrinkling of forehead;
• Twitching of the cheeks, wings of the nose, corners of the mouth;
• Opening the mouth and sticking out the tongue;
• Lip biting;
• Gaze convulsion (eyeballs moving up or to the sides);
• Head twitching;
• Stretching the neck forward or to the sides;
• Shrug;
• Abdominal retraction;
• Twitching of arms, legs;
• Frequent swallowing or coughing;
• Sniffing, etc.

It is also worth noting that children suffering from tic disorders may also have symptoms of psychological dysfunctions accompanying their disease, such as delayed motor development, slowness and disturbances in the smoothness of motor acts, speech difficulties, deficits in attention, spatial functions, as well as programming, regulation and self-control.

Features of the course of the disease

Initially, the child exhibits motor tics, and if the situation worsens, then vocal tics join them. However, there are cases when hyperkinesis begins with sound tics, which significantly complicates diagnosis and delays treatment.

In severe cases, several types of spontaneous movements are observed simultaneously. Sometimes they are accompanied by vocal tics.

Nervous tics in children have their own characteristic features, which make it possible to distinguish them from other pathologies of motor functions. They can be divided into several points:

1. Self-control. It should be noted that it works only in the early stages of the disease. This means that the child can control his seizures, but over time it becomes more and more difficult to do so.
2. Increased symptoms due to stressful situations. The same tendency is observed at the end of the day due to overwork of the nervous system. The autumn-winter period is the peak of the disease.
3. The child's consciousness is not affected in any way. This fact allows us to exclude the development of epilepsy.
4. Hyperkinesis does not occur during sleep. This feature is relevant in the presence of vocal tics and confirms the absence of pathologies of the upper respiratory tract.
5. A nervous eye tic in a child can at first be mistaken for developing conjunctivitis, but soon everything becomes clear.

The following pattern has been noticed: the earlier the disease appears in a child, the more severe it will be. If appropriate measures are not taken, hyperkinesis develops into a chronic form. In this case, treatment is complicated by the fact that several muscle groups may gradually be involved. Pathological movements move from the head to the lower organs and become more complex, vocal tics are added. Doctors assess them as generalized.

Tic manifestations that arise after the age of ten are almost always classified as transient. This means that they disappear spontaneously and unnoticed, just as they appeared. They are also called transient. They do not require special participation from the medical side.

The child began to bite his nails, make strange movements with his hands or head, and often blink or squint for no reason. All these signs may be manifestations of obsessive movement syndrome. We will tell you what it is and what to do about it in this material.

What is it? Obsessive movement neurosis is quite common in childhood. Most often, monotonous repetitive movements or series of such movements appear in children of preschool or primary school age. This is not a separate disease, but a whole complex of disorders both at the mental and emotional levels. The movements that the child makes are unmotivated and are very difficult to control.

Medicine classifies this phenomenon as a manifestation of obsessive-compulsive disorder. Obsessive-compulsive neuroses are included in the classification of diseases. Despite this, childhood syndrome has been studied quite little, and one can only guess about its true causes and mechanisms.

In order not to frighten parents, it should immediately be noted that a child with obsessive movements is not considered mentally ill. He is not disabled, does not need isolation and does not pose any danger to others. The only person he can harm is himself. And even then, only in cases where obsessive movements are traumatic.

Most often, according to current pediatric practice, parents go to the doctor with complaints that the child has begun to bite his lips, chew his legs and skin on his hands, bite his own hands, pull out his hair or almost constantly twirl his hair. finger, wave your arms and shake your hands, swing your body from side to side. It is noteworthy that the baby begins to repeat such movements precisely when he finds himself in an awkward or uncomfortable, from a psychological point of view, situation. If he is afraid, if he is confused, upset, irritated, offended, he begins to compensate for the discomfort with a habitual and calming movement or a whole series of them.

The manifestations of the syndrome do not always have pathological neurological or psychiatric causes. Due to little knowledge, it is sometimes very difficult to establish what became the “trigger mechanism”. But this diagnosis, if given to a child, is not a death sentence and in most cases does not even require classical treatment.

Causes of occurrence It is believed that the main cause of the bad habit of making obsessive movements is severe stress, a deep emotional shock that the child has experienced. Due to the fact that the baby cannot express in words the feelings overwhelming him, emotions find a way out on the physical level. This disorder is usually temporary, and as soon as the baby recovers from the experience, he will be able to get rid of unnecessary movements and actions.

Psychological reasons also include:

mistakes in raising a child (severity, physical punishment, connivance and permissiveness); difficult psychological climate in the family (divorce of parents, scandals and quarrels between adults in front of the child, physical violence); a sharp change in the usual habitat (sudden move, transfer to another school, another kindergarten, transfer to a grandmother, etc.); conflicts between the child and peers.

Physical causes that can lead to the disorder or contribute to its development under unfavorable external conditions include:

history of traumatic brain injury; unfavorable heredity (there are close relatives with mental disorders, diseases of the central nervous system, as well as alcohol or drug abusers); concomitant neurological diagnoses (hyperactivity syndrome); congenital mental illnesses (autism, schizophrenia); congenital pathologies of the brain and central nervous system. Sometimes children experience a whole complex of causes that combine both physical and psychological factors that contribute to the development of obsessive movements. Establishing the true cause is an incredibly difficult task even for an experienced doctor, but it is absolutely necessary to do this in order to know what specific help the child needs. Some of the reasons can be easily resolved by a confidential conversation with the baby or a visit to the office of a child psychologist, but some will have to be treated with medication.

Symptoms Obsessive movement syndrome has a great variety of manifestations. It all depends on the child’s personality, his character, temperament, physical development, and age. Tics are most common in children under six years of age. They are always physiological in nature, involuntary and often disappear as suddenly as they appeared.

Obsessive movements of a more complex level are better influenced by volitional effort. Theoretically, a person can prohibit himself from biting his nails, but the child’s will and motivation are not very good, and therefore he is simply not able to cope with such movements. Most often, obsessive movement syndrome is manifested by the child biting his nails, the skin around them, smacking or twitching his lips with enviable regularity, biting his lips, blinking frequently and deliberately, constantly coughing or sniffling. Sometimes the syndrome manifests itself more pronouncedly - by rocking the body back and forth or from side to side, shaking the head, and unjustifiably waving the arms.

All such movements pose absolutely no danger if they are isolated or occur rarely.

Obsessive-compulsive disorder syndrome is characterized by cyclicality, regularity, monotony and constant repetition of very specific movements.

Often parents try to simply stop such manifestations. If they are pathological in origin, the child does not perceive criticism and demands to stop adequately, the movements intensify, and with the persistence of adults, the baby may begin to become hysterical.

Diagnostics No doctor in the world, when parents come to him with complaints about obsessive movements of a child, will be able to say exactly what is causing this behavior in the baby. Therefore, mom and dad need to take a very careful look at the child, analyze recent events, and only after that go to see a doctor.

It is better to start diagnosing by visiting a neurologist. Parents will have to tell this specialist in detail in what situations and how often the series of movements are repeated, what nature they are, and also whether the child has recently had stress or upheaval.

In addition, you should write down and bring to the doctor a list of all the medications your child has taken over the past couple of months. Some medications can have this effect on the nervous system.

If after this no clear reason is identified, the doctor will advise you to undergo an MRI of the brain (to rule out brain pathologies), and also pay a visit to a child psychiatrist, who will examine the child for mental disorders. It will be useful to take blood and urine tests, which will help determine whether there is any inflammatory process in the body, as well as whether it has a deficiency of vitamins and some minerals (in particular, calcium). Their lack can also lead to disorders of the nervous system.

This is where the available list of diagnostic measures ends. In medicine today there is no single standard for assessing such a condition as obsessive movement neurosis, and therefore doctors will make a diagnosis based mainly on the stories of parents.

Treatment If the psychiatrist and neurologist consider that the child is healthy, and the tests did not show any significant deviations from the norm, then parents should not worry and do not rush to stuff their child with pills and injections. This requires a different approach. Therapy will consist of eliminating all phenomena and events that traumatize the baby’s psyche.

You need to communicate with your child, talk, walk, draw together, watch movies, read. And be sure to discuss everything.

Sooner or later, the baby will definitely report what bothered him so much, and the parents will be able to understand why the obsessive movements arose.

Under no circumstances should you forcefully stop the child’s attempts to make movements; you should not once again focus your attention on them and draw the child’s attention. If the child’s movements pose a danger to himself (he bites himself, scratches his face), you should definitely attend classes with him from a child psychologist, and, if necessary, from a psychotherapist. The baby needs to be monitored more closely.

Medication and concomitant treatment for obsessive movement neurosis are prescribed mainly when medical specialists find justified medical reasons for the occurrence of the disorder.

Medications alone cannot cure neurosis. They only temporarily alleviate the condition and relieve some of the symptoms. And only comprehensive treatment and favorable changes in the baby’s life can help him get rid of obsessive movements completely.

Children are offered a calm developmental and educational program and frequent walks in the fresh air. If the child’s age allows, you can let him spin a fashionable and popular spinner among children and teenagers - it fully satisfies the need to make simple movements during times of emotional instability. Actually, this is what this toy was created for.

A good result, according to reviews from parents who treated obsessive movement syndrome in their children, comes from communication with pets.

As an auxiliary therapy, you can give a child a puppy or a kitten, of course, if the baby is not allergic to wool, and his age allows him to consciously communicate and care for the pet.

Causes

Despite countless years of research into nervous tics in children, doctors have not been able to come to a common point of view regarding the provoking factors. But among many theories, it was found that the most likely are the consequences of traumatic influences. These include:

1. Fright.
2. Fear.
3. Divorce of parents or forced separation from one of them.
4. Change of environment.
5. First of September. The first days of school are extremely stressful for a child.
6. The birth of a second child in the family.

Heredity also plays an important role in the occurrence of tics. Children whose parents experienced hyperkinesis in childhood are much more likely to develop it too.

An unstable situation in the family or immediate environment that a child encounters in kindergarten, school, or in the yard is, of course, the main provoking factor. Children's relationships, communication with peers and adults, can be of a very diverse nature. They often contain conflict situations, and they serve as the starting point of nervous disorders.

Organic brain damage can also cause nervous tics in children. Sometimes they are a consequence of the following events:

• severe maternal pregnancy and difficult childbirth;
• traumatic brain injury;
• a previous neuroinfectious disease.

Separately, it should be mentioned that the reasons for the development of tics may be hidden in a lack of any vitamins, minerals or trace elements.
Since the child’s body is just being formed and is very unstable to external influences, hypovitaminosis can cause disturbances or malfunctions of the nervous system. It has been noticed that the disease progresses in waves. If the child is in a calm, balanced mental state, then tic movements may decrease to minimal manifestations or not be observed at all. At the same time, any stressful situation, fear or anxiety, serves as an impetus for exacerbation of the condition and intensification of tics.

Children's multidisciplinary medical center for children from 0 to 18 years old

09/20/2017 Parents often worry about their child’s condition – is it normal or a symptom of a disease? Therefore, if a healthy baby suddenly begins to constantly blink his eyes or lick his lips, then this becomes a reason for panic.

A nervous tic is an involuntary (obsessive) short-term contraction of one or more muscles, occurring suddenly and repeated many times. Tics in children are very diverse in their manifestations.

By the nature of the manifestations they are divided into motor and vocal

Motors include:

• extension or flexion of fingers;
• frowning or raising the eyebrows;
• grimacing, wrinkling of the nose;
• movement of arms, legs, head or shoulders;
• twitching, licking or biting lips;
• twitching or blinking of the eyes;
• flaring of the nostrils or twitching of the cheeks.

The most common are various facial tics, especially eye movements. Motor hyperkinesis of large parts of the body occurs much less frequently, although they are immediately noticeable, as are vivid vocal actions.

Involuntary, mildly expressed vocal manifestations go unnoticed for a long time. Parents consider them pampering and scold their children, not understanding the reason for the inappropriate sounds made, such as:

• sniffling;
• grunt;
• coughing;
• snort;
• hiss.

Depending on the reasons that led to tics, they are divided into primary and secondary (arising after illnesses or injuries)

Causes of primary tics:

— The most common cause of nervous tics in children is psycho-emotional shock (fear, quarrel with parents, death of loved ones or a pet); tics can also be preceded by a long-term unfavorable psychological situation in the family (lack of attention to the child, excessive demands and strictness in education). — In about 10% of children, a nervous tic debuts in the first days of attending school. This is due to a new environment, new acquaintances, certain rules and restrictions, which is a strong emotional shock for the child. - Eating disorder. A lack of calcium and magnesium in the body, which are involved in muscle contraction, can cause muscle spasms, including tics. — Abuse of psychostimulants. Tea, coffee, all kinds of energy drinks activate the central nervous system, causing it to work “for wear and tear”. With frequent consumption of such drinks, a process of nervous exhaustion occurs, which is manifested by increased irritability, emotional instability and, as a result, nervous tics. - Overwork. Chronic lack of sleep, long periods of time at the computer, reading books in poor lighting. — Hereditary predisposition

Factors contributing to the occurrence of secondary nervous tics are:

— congenital diseases of the nervous system; - traumatic brain injury, including congenital; - encephalitis - an infectious-inflammatory disease of the brain - herpes virus, cytomegalovirus, streptococcus; - brain tumors; - some medications - antipsychotics, antidepressants, anticonvulsants, central nervous system stimulants (caffeine); - trigeminal neuralgia; - hereditary diseases - Huntington's chorea, torsion dystonia.

Approximately 10 - 15% of primary nervous tics, being mild, do not have a serious impact on the health and psycho-emotional state of the child and go away on their own after some time (weeks - months). If a nervous tic is severe, causes discomfort to the child and negatively affects his psycho-emotional state, it is necessary to begin treatment as early as possible to prevent the progression of the disease.

Treatment of nervous tics is carried out under the supervision of a pediatric neurologist and may include:

— individual psychotherapy; - creating a favorable environment in the family; — organization of work and rest schedules; - good sleep; - good nutrition; - elimination of nervous tension; - drug treatment; — physical therapy.

Parents should remember that a healthy, trusting atmosphere in the family can have a beneficial effect on the baby’s condition. Pay more attention to your child, find an activity that will bring pleasure to both you and your child. It is worth spending more time in the fresh air, be sure to play sports and teach your child to properly throw out negative emotions, as well as reduce the amount of time spent playing video games and watching TV.

Be healthy!

Still have questions? Make an appointment with a pediatric neurologist.

Phone number for appointment

Diagnostic procedures

Before starting any treatment, you need to have your child examined by a specialist. After the initial examination, the neurologist refers the patient to undergo electroencephalography. It makes it possible to identify the following indicators:

• local cerebral disorders;
• foci of pathological activity;
• analysis of the state of brain activity.

Repeated studies allow you to monitor the effectiveness of the therapy. A biochemical blood test is mandatory. If the doctor deems it necessary, the child may be sent for an MRI.

Identifying nervous tics in young children, establishing their causes and prescribing adequate treatment is the task of a neurologist. But the direct responsibility of parents is to ensure a comfortable stay for the child at home, in an educational institution or on the street. It is necessary to find out the factors that pose a threat to the baby’s psyche and eliminate them in any way.

Classification

Tics are classified according to several factors:

• According to etiology - primary (inherited), secondary (organic origin) and cryptogenic (can occur in a healthy child);
• According to symptoms - local, widespread effects, general, vocal;
• By severity - serial and single, tic status (continuous twitching over a short period of time, severe hyperkinetic state);
• According to the ICD - transient (facial twitching), chronic (from remitting to persistent and tic status), Tourette's syndrome (motor and vocal cord tics).

Treatment

Very often, children who are diagnosed with tic hyperkinesis do not need special therapy. It is absolutely meaningless, and only correction of the patient’s lifestyle helps. However, if the tics become generalized, then treatment cannot be avoided. But which method the doctor chooses depends on the severity of the disease, age and physical characteristics of the child.

An integrated approach to treating tics in children is possible. It includes:

1. Activities aimed at properly organizing the child’s daily routine. Protecting him from stress, anxiety and other troubles.
2. Drug-free therapy. This complex includes a visit to a psychotherapist, physiotherapeutic procedures, and reflexology.
3. Treatment with medications.

At the initial stages of the development of tics in young children, only routine measures are sufficient for visible positive dynamics. Rationally organized time for activities and rest, timely going to bed, proper nutrition, and exercise are the key to a positive outcome from a nervous disorder.

Family psychotherapy is of no small importance. If the situation in the family has given impetus to the development of tics, then you need to try to correct it. Under no circumstances should the child witness quarrels or scandals. It is necessary to create a calm, trusting environment so that the child feels loved and protected. You should not pull back or remind him of his nervous disorder, as this will only aggravate the situation.

Good results in the prevention and treatment of tics are provided by educational games using fine motor skills, art therapy, and relaxation. The most commonly used physiotherapeutic methods to combat this disorder are:

• biofeedback method;
• audiovisual stimulation method;
• acupuncture;
• laser therapy;
• ozokerite applications;
• massage of the cervical-collar area;
• electrosleep.

In cases where drug treatment cannot be avoided, sedatives are first prescribed.
They have a general calming effect, remove nervousness and irritability. If the expected effect is not observed, the doctor prescribes tranquilizers. Their scope of action is the relief of emotional stress, anxiety and fears. With progressive tic hyperkinesis, which is not amenable to gentle treatment, more severe drugs are used. These include antipsychotics and antidepressants. Unfortunately, these medications have a lot of side effects and are used only as a last resort, only as prescribed by a doctor and strictly following the dosage. The main indicator for use is the safety of the child, taking into account the special sensitivity of the not yet formed organism, including the nervous system.

Treatment of tics in children is usually carried out on an outpatient basis, since hospitalization can be an additional source of anxiety. For the same reason, drug therapy is avoided by injection.

Childhood tics: symptoms, causes, treatment

Have you noticed that your child is blinking more often than usual, twitching his shoulders and coughing? Perhaps these are manifestations of tics. The chief pediatric neurologist of the Ministry of Health of the Tver Region, Galina Anatolyevna Zueva, will tell you why they occur and how to treat them correctly.

What are tiki?

Tics are involuntary violent movements that occur in certain muscle groups.

Tics most often occur in children aged 4 to 6 years . This is due to the maturation of the subcortical parts of the brain, which most often ends by the age of seven or eight years.

If for some reason the child’s body produces a little more activating (or, conversely, fewer inhibitory) neurons than required, and the regime of motor and other loads is not observed, then problems begin. This could be attention deficit hyperactivity disorder, or sleep disorders, or tics.

From three to four years old, your baby begins to grow very actively and explore the world. In order for the cognitive function to be rapid, for him to absorb a large amount of information, and for the brain to mature, the child needs a lot of activating neurotransmitters. He must have time to climb everywhere, jump, look, speak, talk, ask a bunch of questions, understand and assimilate everything he hears. If activating neurotransmitters are used correctly, then the child develops harmoniously: he is nimble, but at the same time he can control himself, follow the rules, and show perseverance during kindergarten classes. It is completely normal that your child is active, inquisitive, and fast. When a baby does not use these neurotransmitters for movement, communication, and learning (for example, he sits at home all day and is not allowed to go outside), then various problems may arise: hyperactivity syndrome, sleep disturbances, and behavior problems.

So, for a child to develop properly, he must run a lot, climb, talk, explore the world around him, and experience various emotions. This forms spatial-imaginative thinking, motor skills, synchronicity of the two hemispheres, develops the brain and at the same time correctly wastes all the produced neurotransmitters of activity. At the age of 3-5 years, a child is nimble, he switches quickly, but at the same time copes with his tasks: if he needs to sit, he will sit normally, study, do something. This is the standard development of a child that should be.

Types of tics in children

Most often, children aged 3-6 years have motor and vocal tics.

Motor tics are tics associated with movement: blinking, blinking, closing your eyes, twitching your nose, tugging at clothes, moving your shoulders, etc.

Vocal - tics associated with breathing. These are all kinds of hemming, sniffing, coughing, whistling. By the way, a common case in my practice: a child coughs for a long time, he is taken to doctors, they look for the cause, but in fact he has a vocal tic, which needs to be treated by a neurologist. This will not necessarily turn out to be a tick, but this also happens, and this must be taken into account.

Combinations of several tics occur quite often. For example, blinking, twitching the corners of the nose and behaving with the shoulders at the same time. Tics can also be more pronounced when certain muscle groups are involved at the time of the tic disorder, so-called segmental tics . There may be a combination of motor and vocal tics, such as eye blinking and grunting at the same time. At the same time, he can independently delay the manifestation of the tic for some time (up to several seconds) and repeat it upon request. This is the so-called duplication, which is a distinctive feature of tics from other types of obsessive movements - hyperkinesis.

A separate, most complex case of generalized tics is Tourette syndrome , when tic manifestations occur in multiple muscle groups, when the same child has several types of vocal tics. They are very pronounced and cause great inconvenience to the child. In this case, examination and treatment by a neurologist is strictly required.

Tics can be transient, i.e. appeared, were observed in the child for some time, and then went away. But if the tics continue for more than a year, then these are already chronic tics , so examination and treatment are required.

Causes of tics in children

As we have already said, this is a lesion of the subcortical formations in the child’s brain. It may be due to the development of the brain or be damaged by some factor.

A sedentary lifestyle is one of the most common triggers for tics. When a child is not active enough, he does not use up all the activity neurotransmitters. Muscles need to move, but they don't get it. As a result, tics occur. The child must run, and it is better not along a flat asphalt path, but along a forest path, where you need to crawl under a tree somewhere, run along a log, and turn away from the root. All this better shapes the nervous system and helps develop spatial-imaginative thinking. No chance to go to the forest? In the park, leave the level path and walk along the dirt path, just dress appropriately so that both you and your baby feel comfortable. This is one of the common mistakes of parents: they spend hours walking in parks, walking smartly along the paths, but this is of little benefit. It is much more useful for a child to be closer to nature, to study, to learn. And the many emotions that he receives at the same time correctly expend the energy inherent in him. When a child sits at home all day with a tablet, this energy accumulates, and then results in fights, disobedience, and tics, among other things.

Children with attention deficit disorder are especially susceptible to tics . Because of their illness, they already have a disruption in the formation of neurotransmitters, and when we do not allow them to fully expend all this energy, various problems appear: headaches, insomnia, tics.

An unfavorable psycho-emotional environment is another common cause of tics in children. For example, if a child really does not like going to kindergarten, which causes negative emotions in him and creates a lot of stress, and the parents do not have time to discuss this situation with him, explain it, and come to an agreement. In this case, the child’s nervousness can also have a side effect in the form of a tic.

Some difficult situation in the family , for example, when parents demand high results from the child in all subjects, forming the so-called excellent student syndrome. The child is afraid of not being able to cope, he has a great responsibility, and as a result, neuroses and tics arise, most often vocal ones. Moreover, they can persist for a long time, manifesting themselves in stressful situations.

A common cause of tics is a divergence of views on raising a child in the same family . When, for example, parents treat him strictly, and grandparents, on the contrary, indulge all his whims. The child ceases to understand how to behave, and this leads to neurosis.

All this applies to common tics in children aged 4 to 6 years. But there are also more difficult cases. If tics appear in children over seven years of age , then the reason is no longer due to the normal maturation of the body, but to some kind of pathology.

This may be a consequence of having suffered from frequent sore throats, streptococcus , when an autoimmune process occurs that damages the subcortical formations and malfunctions in the form of various tics or hyperkinesis. They definitely need to be treated.

The cause may also be the consequences of frequent mononucleosis ; this virus also often affects the subcortical nuclei.

There are a number of hereditary diseases that cause tics. They are rare, but still. For example, diseases associated with impaired proper breakdown of copper and iron. Among them is Wilson-Konovalov disease, in which copper begins to be deposited in the liver and other internal organs, including in the subcortical formations of the brain and leads to various types of hyperkinesis and tics. These diseases must be excluded in children with tics.

When is it necessary to treat tics in children?

If these are single simple motor tics in a child aged 4 to 6 years, they are rare and do not interfere with the child’s life, then most likely this is due to a slight excess of neurotransmitters. Such tics do not need to be treated ; they will go away on their own in a year or two.

However, if tics are frequent and prevent the child from concentrating, then, of course, this needs to be examined and treated .

Pay special attention to tics that appear in a child after 7-8 years . They definitely need to be examined and the cause of their occurrence must be found out.

I must say that tics can be treated well . Now there are quite a lot of high-quality drugs. It is important here that the doctor correctly selects the right medicine and dosage. To treat tics, a special dosage regimen is used; the dosage here is slightly higher than usual, but you should not worry about this - the drugs are well tolerated and will not harm the child’s health. Sometimes for chronic tics, medications are given for the entire school year.

Prevention of tics in children

Follow these simple recommendations, and your child will grow up healthy and happy.

Walk with your child as much as possible. It’s good if he runs not only around the yard or a flat path, but also along earthen paths with some small obstacles. To do this, just leave the main alley in the park and go explore the lawns.

Study natural phenomena. Listen to the sounds of nature, teach your child to distinguish between them, and learn with him the laws of the world around him. All this will not only develop the baby’s brain, but will also help him use neurotransmitters usefully and cope with stress.

Play active games with your child. It is considered normal when a child aged 2 to 5 years spends about 10 hours a day in active movement. Let's say he worked out, drew, then ran in the yard, played with the dog, went down the slide, explored something, met someone on the playground, talked, then rested and ran back to play. Then the neurotransmitters will be used correctly and the child will not have problems with sleep, nervousness, or behavior.

Talk to your child. And this is a very important point. Something that many parents often forget. In the meantime, it is conversations with the baby that can solve many neurological problems. It is important not just to talk to your child, but also to listen to what he says back to you. From the age of two, the child has every right to make some decisions, to choose something - for example, what T-shirt to wear for a walk or what color to take a toy. Give him the opportunity to participate in the life of the family, listen to his opinion. You need to understand that this opinion must be reasoned, that is, not just “I want”, but “I want because...” This will not only help you create and maintain a trusting relationship with your child, but will also keep him healthy and save him from a variety of behavioral problems.

Good luck to you and your children!

Possible consequences

Nervous tics in children of different ages, regardless of the cause, are signals that not everything is all right with the child, his mental state is at the limit of his capabilities, and he needs immediate help. If the irritant is removed in time, the tic manifestations go away spontaneously.

What happens if you leave everything as is? There are several possible scenarios here:

1. Epilepsy. Tics may be symptoms of the early stages of this severe neurological disease.
2. Severe neuroses, psycho-emotional disorders. Untreated hyperkinesis progresses in the child’s body, causing new manifestations of the tic condition. Lack of qualified help leads to the development of depression and other critical conditions.
3. Tourette's syndrome. Although this mental disorder is not a consequence of parental inactivity, its clinical picture necessarily includes both motor and vocal tics.

Even if hyperkinesis disappears on its own after a week without any consequences, it is necessary to go to the doctor and undergo diagnostic procedures. This is a guarantee of the child’s health, and is done with the aim of eliminating the above diseases.

Classification of tic disorders

Classification of tic disorders can be carried out on several most significant grounds.

According to etiology (origin of the disease), tics are divided into:

• Primary – occur in the absence of any other disorder, are the only symptom of the disease and are often associated with the child’s hereditary predisposition.
• Secondary – occurs against the background of another disease.

According to clinical manifestations, tics are:

• Motor (motor) - are divided into simple (for example, blinking, opening the mouth), and complex, occurring in the form of entire coordinated movements (for example, jumping).
• Vocal (vocal, sound) - also divided into simple, manifested in the form of individual sounds (sniffling, coughing, snorting, squeaking), and complex, representing words or phrases of a socially unacceptable nature (coprolalia), repetition of words and statements of another person (echolalia ), or your own words and phrases (palilalia).
• Sensory – represent repeated sensory sensations (cold, pressure, burning) in the same part of the body.
• Ritual - manifested in the form of repeated complex actions such as walking in a circle.

Based on their duration, the following types of tics are distinguished:

• Transient - occur daily in a child for at least 1 month, but persist for no more than 1 year.
• Chronic – occur almost daily or intermittently in a child for more than 1 year.

And finally, according to the degree of severity, tics are divided into:

• Local – occurs with the involvement of one muscle or one group of muscles.
• Multiple – occur with the simultaneous involvement of several muscle groups.
• Generalized , or Tourette's syndrome, is a hereditary disease that involves a combination of multiple motor and vocal tics with the gradual involvement of coprolalia (repeated shouting of socially unacceptable words or phrases).

Adaptation in society

Children, as we know, are cruel by nature, so it will be very problematic for a child with obvious manifestations of hyperkinesis to adapt to a new team. But it’s not his fault that the nervous tic happened to him. When communicating with adults, it is very important for him to feel a tolerant attitude. And if at home they constantly focus attention on this topic and reprimand the child, believing that he is doing this on purpose, the situation only gets worse.

Parents should be completely on the side of the child, and he should feel this not only in words. This is what it should look like:

• all conversations about nervous disorders, including tics, should be prohibited, especially in the presence of a baby.
• do not focus on the problem, behave freely and naturally.
• conduct an explanatory conversation with teachers or educators of the team that the child attends, and call on them for assistance.
• choose a suitable leisure activity for your child. Single active sports, such as skiing or swimming, are encouraged.
• provide nutritious and varied nutrition.

During adolescence, a teenager’s body is unpredictable, and also undergoes hormonal changes. If at this stage nervous tics are also detected, then this can generally turn into a personal tragedy. First of all, self-esteem suffers; the child withdraws into himself, does not want to communicate with anyone, and is fixated only on his illness.

The parents’ task is to consider the threat in time and take all measures to eliminate it. Even if the tics do not go away on their own, there is every chance that properly selected therapy or medication will help get rid of them. In any case, you can and should strive to live a full life.

Tics and obsessive movements

It was believed that nervous tics arise during age-related crises (new stages of independence), which are observed at 3-4 years and 7-8 years.

It is at this time that children first encounter developmental crises:

• new skills are acquired;
• the child's behavior changes;
• personal characteristics are being formed.

The cause of this condition is, on the one hand, instability of work, immaturity of the nervous system as a result of:

• Chronic intrauterine hypoxia:
• maternal diseases during pregnancy (blood diseases, cardiovascular pathology, diabetes mellitus);
• Intrauterine infections:
• Acute hypoxia during childbirth:
• Birth injuries.
• Taking medications by the mother during pregnancy.
• Prescribing medications for a newborn after birth.
• Bilirubin encephalopathy as a result of prolonged jaundice.

The cause of tics and obsessive movements can be regular long-term spending of time in front of a TV screen or at a computer - this disrupts the alpha rhythm in the brain, which is responsible for the calm and tranquility of the baby.

As well as low physical activity of the child.

Acute stress is considered the main provoking factor:

• acute or chronic traumatic situation that the child cannot cope with on his own;
• constant noise or other irritants;
• psychological trauma in a child;
• frequent somatic diseases.

Anxiety is considered a protective mechanism of the brain to prepare in advance for the onset of a dangerous event and speed up reflex activity.

Therefore, during this period, the baby’s brain is in a state of constant anxiety and anticipation of danger. At the same time, the ability to voluntarily suppress the excessive activity of brain cells is gradually lost.

It must be remembered that tics cannot occur in an infant - any obsessive movements at this age are associated with organic pathology of the nervous system and brain and require immediate diagnosis and treatment.

The danger lies in the fact that these movements become fixed in the form of a pathological habit, which over time transforms into tics, and subsequently into the neurosis of obsessive movements.

For mild cases of the disease, sometimes a course of sessions with a neuropsychologist, psychologist or behavioral therapist is sufficient. But you definitely need:

• temporarily limit computer use and TV viewing;
• spends more time outdoors with the child;
• examine your health condition and eliminate all possible somatic causes. If necessary, various sedatives are prescribed;
• organize more movements and physical activity;
• art therapy activities, music therapy, neurocorrectional classes have a beneficial effect;

In addition, you need to realize that the causes of this disease lie in the psycho-emotional sphere. Very often, tics and obsessive movements are just the tip of the iceberg, which is visible to the naked eye, and the problems lie deeper. And if you try to eliminate the manifestations of (i.e.) tic, the problem (failure, conflicts, stress, overexertion, low neurodynamics, lack of communication skills, school “failure”) may worsen, and the SOS signal for others and parents may become louder and stronger - develop into enuresis, logoneurosis, encopresis. Therefore, ignoring or trying to solve the problem of obsessive movements by keeping silent, making comments, or pulling back can lead to an even greater intensification and complication of the problem.

Prevention Tips

To prevent a child’s nervous tics from developing into more serious mental disorders over time, all possible measures must be taken to prevent them. You don't need anything supernatural to do this. It will be enough not to forget that the baby sees the behavior of the parents and people around him, draws his own conclusions and evaluates the events taking place due to his level of development.

The psyche of a child at an early age is unstable and vulnerable, so any clarification of the relationship between parents in a raised voice is a stressful situation that can lead to tic manifestations. It is in the family that the child should feel support and understanding. This is his fortress, in which, if necessary, he can hide from all his fears. If there is no such relationship, then the risk of developing tics is quite high.

Children living in a calm, friendly environment are very rarely susceptible to nervous tics. To avoid having to treat the consequences of mental imbalance in a child, it is enough to create comfortable conditions for him. They are as follows:

• avoidance of anxiety and stressful situations;
• healthy, full sleep;
• high-quality and healthy food, a ban on fast food and overly sweet and fried foods;
• compliance with the daily routine, proper organization of rest;
• dosed computer use and TV viewing;
• maximum exposure to fresh air;
• classes in sports sections that match the interests and temperament of the child;
• inadmissibility of overwork.

In rare cases, raising the younger generation does not involve punishment. They are certainly necessary, but within reason. Physical impact is immediately excluded. Only moral methods of influence are acceptable. The child must clearly know what offense he is being punished for and how he should have done the right thing. At the same time, you should assure the child that punishment does not affect his love for him. Only in such a situation will he draw the right conclusions and receive minimal nervous shock.

Even if the appearance of nervous tics in a child could not be avoided, it should be remembered that this is not the worst thing that could happen to him. Modern medicine, combined with parental care and attention, can work wonders.

How is this treated?

Treatment of tics is carried out on an outpatient basis, and it should combine not only drug treatment (depending on the severity of symptoms and many other factors), but also:

• Psychotherapy including family, behavioral and play therapy.
• Psychosocial therapy. Which includes: correct understanding of symptoms, taking into account the child’s needs and much more. Moreover, it is indicated even with harmonious relationships in the family.
• Therapeutic and pedagogical influence.

Which, in an integrated approach to treatment, gives a good prognosis in 60–70% of patients.