Facial Tics

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Facial Tic
Facial Tic

Tics and twitches can occur throughout the body and in many cases the names “tics” and “twitches” are used synonymously but there are definite distinctions between the two.

Twitches are completely involuntary sudden muscular movements often occurring as single events whereas tics tend to be a repetitive series of muscle contractions which can sometimes be predicted by the patient and the onset of which may even be controlled and put off for a short time but eventually the tic will manifest itself despite any attempts to prevent it.

Facial tics are extremely common and it is fair to say that everyone, at some time, will experience some degree of facial tic activity. In many cases, this may be nothing more than the uncontrollable flickering of an eyelid. The face, of course, has many different muscles some of which are associated with basic functions such as eating and blinking and others used for communication by facial expression.

Tics can affect different muscles and typical facial tics include the wrinkling of the nose, excessive blinking, grimacing, eyebrow raising or mouth movements such as the protrusion of the bottom lip or even sticking out the tongue. In addition to these very visible “motor” tics, vocal or phonic tics may also occur with various different sounds being emitted such as a cough, grunt, sniff, squeak, barking sound or throat clearance. Another similar but unrelated condition is that of hiccups (hiccoughs) which is due to an involuntary spasm of the diaphragm.

What Causes Facial Tics?

In the vast majority of cases, there is no known cause for this disorder. It is generally considered to be due to random inappropriate nerve impulses from within the brain but is rarely associated with any disease process. The exceptions are tics due to Huntington’s syndrome and neurological disorders such as cerebral palsy. Tics of all types, including facial, are most commonly seen in children often appearing from around the age of five to eight years and these often subside, or disappear completely around the time of puberty although some may continue into adult life. Tics may also suddenly appear in adulthood for no identifiable reason. Although the precise cause of tics may not be known, it is widely accepted that certain factors can influence the likelihood of their occurrence. Stress, anxiety and tiredness are often cited as likely precursors. Generally being nervous can result in the onset of tics and in some cases they may manifest themselves during speech similar to a stammer.

The use of illegal drugs such as cocaine or amphetamines can result in a tic disorder. It has also been observed that tics tend to occur more in some families than others so some people simply have a genetic predisposition to this condition. Tics also frequently appear as part of behavioural disorders such as Tourette’s syndrome, attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD) and autism. Another rather annoying feature of facial tics is that they appear to be attention seekers and any attempt to control them, such as by telling a patient “not to do that”, is likely to result in the condition worsening.

Stress, anxiety and tiredness are often cited as likely precursors. Generally being nervous can result in the onset of tics and in some cases they may manifest themselves during speech similar to a stammer. The use of illegal drugs such as cocaine or amphetamines can result in a tic disorder. It has also been observed that tics tend to occur more in some families than others so some people simply have a genetic predisposition to this condition. Tics also frequently appear as part of behavioural disorders such as Tourette’s syndrome, attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD) and autism. Another rather annoying feature of facial tics is that they appear to be attention seekers and any attempt to control them, such as by telling a patient “not to do that”, is likely to result in the condition worsening.

How to Stop Facial Tics

Facial tics may be transient, lasting only for a few months, or a more long-lasting chronic condition but are generally regarded as being of little medical significance. Mouth tics are probably the most troublesome as bite injuries may occur and in severe cases, a dental tooth guard may be required but the simple use of chewing gum may be sufficient to prevent or reduce such episodes.

The general theory is that if muscles are already being employed, they are unlikely to suddenly go into tic mode. This is the basis of habit reversal therapy (HRT) and the deliberate and controlled use or tensing of a muscle can prevent such episodes from occurring. This type of therapy is often quite difficult to learn and it requires the patient to recognise the sensations and urges leading up to a tic episode in order to be ready to offer a competing response. A similar system is employed in the treatment of stammering. The avoidance of stress, anxiety and tiredness can also be beneficial and having a positive outlook on life also helps. Boredom and lethargy should be avoided and active interests such as sports and hobbies often result in positive improvements. In some of the most severe cases, medical intervention may be unavoidable and drugs to control the symptoms are available often being neuroleptics (antipsychotics) which modify brain activity.

Facial Tics in Autism

Autism is a complex condition often characterised by obsessional ritualistic behaviour and repetition. Tics do not form a major part in the condition but are frequently observed as an additional complication. Milder forms of autism such as Tourette’s syndrome commonly feature tics especially vocal tics which may take the form, not only of making a noise, but also in the repetition of swear words.

Facial tics can form a very distressing condition. From a medical viewpoint, they usually have little or no significance but psychologically, they can lead to depression, anxiety and social exclusion all of which are likely to make the condition worse.

Children, in particular, may experience bullying potentially leading to serious mental health problems in the future. For reasons which are not fully understood, boys are three to four times more like to suffer from tic disorders than girls. So the treatment of tics usually involves lifestyle changes and actively controlling stress. In some cases, medical professionals may be needed to help with suitable therapies or, in the most severe cases, by the prescription of drugs. In the majority of cases, tic disorders tend to subside with time and even the so-called chronic cases, tend to be time-limited. Probably the worst thing to do is to about facial tics is to worry excessively as this will probably make the condition worse.

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