Chronic Motor Tic Disorder

Chronic motor tic disorder is a condition that involves either brief, uncontrollable, spasm-like movements or vocal outbursts but not both. (If both a physical tic and vocal outburst are present, the condition is known as Tourette syndrome and not chronic motor tic disorder.)

Chronic motor tic disorder is more common than Tourette syndrome but less common that transient tic disorder. Between one and two percent of the population have this disorder. It is not curable. Treatment can help lessen the disorder’s affect on an individual’s school or work life.

Doctors are not entirely sure what causes motor tic disorder and why some children develop it earlier than others. It’s thought that chronic motor tic disorder may be the result of physical or chemical abnormalities in the brain. It may be that neurotransmitters, which are chemicals that transmit signals throughout the brain, are misfiring or not communicating correctly. This causes the same “message” to be sent over and over again. The result is a physical tic.

Children with a family history of a chronic tic or twitch are more likely to develop chronic motor tic disorder. Boys are more likely to have chronic motor tic disorder than girls.

People with chronic motor tic disorder may display the following symptoms:

• facial grimacing
• excessive blinking, twitching, jerking, or shrugging
• sudden, uncontrollable movements of the legs, arms, or body
• sounds such as throat clearing, grunts, or groans

Tics may be made worse by the following:

• excitement or stimulation
• fatigue or sleep depravation
• stress
• extreme temperatures

People with chronic motor tic disorder are usually able to restrain their symptoms for short periods of time. However, it takes effort, and giving in to a tic brings a sense of relief. According to the National Institutes of Health, individuals report that they experience strange sensations in the part of the body before a tic occurs (NIH, 2012).

Tics are typically diagnosed during a regular office appointment. Doctors rarely request tests to diagnose a tic. In fact, there are really no tests that can diagnose the condition.

Doctors will check your child for two requirements before diagnosing him or her with chronic motor tic disorder:

• The tics must occur almost every day for more than a year.
• The tics must be present without a tic-free period of longer than three months.

The type of treatment an individual receives for chronic motor tic disorder will depend on the severity of the condition and how it affects his or her life.

Behavioral Therapy

Behavioral treatments can help a child learn to restrain a tic for a short period of time. A 2010 study published in the Journal of the American Medical Association found that a treatment approach called comprehensive behavioral therapy for tics (CBIT) significantly improved symptoms in children (Placentini, et al., 2010). In CBIT, children with tics are trained to recognize the urge to tic, and to use a replacement or competing response instead of the tic.

Medication

Medication can help control or reduce the tics. Dopamine blockers such as fluphenazine, haloperidol, pimozide, and risperidone are frequently used to control tics. Side effects of these medications can, however, be serious. Side effects include movement disorders and blunted thinking.

Other Medical Treatments

Injections of botulinum toxin (commonly known as “Botox” injections) are used to treat some dystonic tics. Dystonic tics are tics that appear as abrupt bursts of movements, followed by a sustained contraction.

Some individuals have found relief through brain stimulation by implanted electrodes.

Children who develop chronic motor tic disorder between the ages of 6 and 8 usually do very well. Their symptoms typically stop in four to six years without treatment. Older children who develop the condition and continue to experience symptoms in their 20s may not outgrow the tic disorder. In those cases it may become a life-long condition.