Nervous tics in children - recommendations from Dr. Komarovsky

Article:

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 TIKS

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.

Causes of primary tics

Primary muscle dyskinesia is an independent deviation in the functioning of the nervous system. It appears after stress, fear (death of a loved one, divorce, car accident). Involuntary movements also occur in children whose parents often scream, swear, or abuse alcohol.

Spontaneous motor activity appears in every tenth first-grader. Many kids find it difficult to cope with the school load. In addition, during this period, parents tighten their demands, more often show dissatisfaction, and punish for bad grades and behavior. Nervous contractions also occur when moving to another city or going to a new school.

Hereditary predisposition is a common cause of nervous tics in children.

Muscle dyskinesia appears in babies whose diet lacks foods rich in magnesium and potassium. The first signs of a lack of these substances are night cramps. If parents do not change the diet of their son/daughter, muscle contractions also occur during the daytime. According to Komarovsky, the situation is aggravated by the consumption of caffeinated drinks.

Nervous vocal tics (whistles, coughing, whispering certain words or phrases) often indicate excessive mental and mental stress. They appear in children whose parents demand excellent grades in school and high results in sports and creative competitions.

VARIETIES 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.

Nervous tics in children: where to turn for help?

If you notice a nervous tic in your child, you should consult a specialist. The First Children's Medical Center offers assistance from qualified child psychiatrists.

Child psychiatrists at the First Children's Medical Center are ready to help the family at any moment and in the most difficult situation. Contact professionals to maintain your child’s mental health!

You can make an appointment with a child psychiatrist in Saratov from 8.00 to 20.00 by calling (8452) 244-000. Reception is by appointment only.

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.

Nervous tic in a child

Answered by Ryltsov A. Yu.

This is most likely a tic disorder.
• In the vast majority of cases, childhood tics do not require pharmacological treatment, and the tic disorder resolves spontaneously.

• First of all, it is necessary to interpret the problem at a face-to-face appointment with a child neurologist and psychiatrist. Tourette's syndrome must be excluded.

• Then, most likely, psychological and pedagogical measures planned by a child psychotherapist-psychiatrist and/or psychologist will be sufficient.

Read about ticks here . If domestic sources are not enough, I can offer imported ones. the Current Management in Child Neurology manual says about tics :

My translation:

Tic disorders. Tics are sudden, short, involuntary movements or sounds that occur in a series of repeated episodes. Tics are a relatively common paroxysmal non-epileptic disorder that comes to the attention of pediatric neurologists. Although the origin of tics is still being studied, autosomal dominant inheritance has been suggested in large pedigrees where relatives have simple tics, complex motor tics, or Tourette's syndrome.

The clinical spectrum of tic disorders includes the more common and benign transient tic disorder, and the more rare chronic (eg, daily tics for more than a year), motor or vocal tics, Tourette's syndrome. In children, the most common motor tics are: facial, neck, and shoulder tics; Breathing tics, consisting of short snorting or snorting sounds, may also be diagnosed. Vocal tics typically consist of short sounds (eg, squeaks), utterances, echolalia, or, less commonly, coprolalia. Children may voluntarily suppress tics, leading to the feeling that they are voluntary or “in their heads.” However, suppression of tics will lead to an internal need to realize them, with subsequent relief after the execution of the tic.

Benign transient tics may manifest as simple motor tics, which can be quite variable, giving the appearance of “migratory” tics. Their relatively sudden appearance often leads to an emergency consultation with a pediatric neurologist due to suspected epilepsy.

Treatment consists, first of all, of educating the patient/parents and the difficult method of treatment with a “potion from time”, because
Transient tics (by definition) resolve within a few months. There are drugs that have shown some effectiveness for tics, such as pimozide and haloperidol, however, pharmacological intervention should be reserved for severe, disabling tics. All answers

FEATURES 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.

REASONS FOR THE APPEARANCE

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.

What are the reasons?

Various stress factors (for example, fear) play a certain role in the occurrence of tics. At the same time, positive and negative experiences can lead to increased tics. Although there are other reasons (for example, Gilles de la Tourette's syndrome is genetically determined).

Parents often associate the appearance of childhood tics with stress and emotional turmoil. In fact, tics are caused by changes in metabolism (dopamine and norepinephrine) in the subcortical structures of the brain. A person is born with similar predispositions and is often inherited.

Tics are not always stressful. There is not always a connection between the occurrence of tics and the experience of stress. A child can grow up in a prosperous and happy family, but one day, without external reasons, due to the peculiarities of brain development, a mechanism turns on and clinical symptoms appear.

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.

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.

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.

What are nervous tics

Very often, parents notice tics, but do not take them seriously, confusing characteristic manifestations with pampering. If the twitching of the eyelids of adults is immediately alarming, then symptoms such as hissing, coughing, various movements of the limbs and sniffling may be perceived incorrectly. To learn in more detail about the features of the course of the pathology, it is important to familiarize yourself with certain facts:

• the child does not feel discomfort during involuntary motor activity;
• nervous tics appear only during wakefulness;
• children can stop (suppress) obsessive movements, but after a while relapses begin and symptoms appear again;
• if the situation worsens, a combination of different types of tics (motor and vocal) may be observed.

Evgeny Komarovsky often says that in the first years of life the nervous system develops, and not always everything goes smoothly. If unfavorable symptoms appear, you should not panic too much, but you still need to tell a specialist about your worries.

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.

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.