The nervous tics They are movements or sounds produced in an abrupt and involuntary way, which deviate in an obvious way from the usual way of behaving of a person. They generally occur on the face, and affect only one muscle; but they can appear anywhere on the body and be much more complex.
Nervous tics can be caused both by simple muscular stress, and by various psychological conditions. In some cases, they are simply reactions to a tired or altered emotional state, while in others they could arise as a symptom of a more complicated pathology, such as Tourette syndrome.
There are different types of nervous tics. Some may arise in isolation, while others follow a more or less regular pattern. On the other hand, although most have to do with involuntary movements, some tics have to do with sounds uncontrolled consciously by the person.
Nervous tics usually occur in children, appearing for the first time around the age of five and decreasing in frequency over time. They are also more frequent in men than in women. However, anyone can suffer them, regardless of age, gender or condition..
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There are different classifications for nervous tics, depending on whether they appear on whether they affect a single muscle or several, the type of movement they produce, whether they occur on the face or the rest of the body, and whether they have to do with movements or, on the contrary, are related to vocalizations.
Next we will see which are the most important types that exist.
Single or simple tics generally consist of sudden, short movements that involve a single muscle group. They often occur on the face, although they can appear anywhere on the body. They are generally not part of a pattern, but can sometimes occur in a rhythmic and predictable way.
Some of the more common isolated tics involve movements such as involuntary blinks, mouth gestures, shrugs, or hand movements. On some occasions, it is also possible that they occur in the extremities, generating movements in the legs and arms..
On the other hand, within the group of isolated tics we can also find some of a vocal nature. Among the most common are throat clearing, grunting, or sniffing..
Complex or compound tics are quite different from simple ones in several ways. On the one hand, they tend to last longer than the first ones. In addition to this, they give the impression of being more voluntary, and they often occur whenever a certain situation arises..
The key to distinguishing complex from simple nerve tics lies in the number of muscles that are involved. In singles, there is only one muscle group moving. In the complexes, on the other hand, several are involved, and may even affect the whole body.
Like simple ones, complex tics can be motor or vocal. Among the first, we can find examples such as touching objects or people, pulling one's clothes, imitating an interlocutor or an unknown person, or the involuntary performance of obscene or rude gestures..
Among complex vocal tics, the most common is echolalia. It consists of repeating the words that another person has said out loud. Others of the most common are lexilalia (saying words aloud after reading them), palilalia (repeating the words that you say yourself) and coprolalia (saying offensive or taboo words aloud).
Depending on the type of movement they produce and its duration, nervous tics can be classified into three categories: clonic, tonic and dystonic..
Click ticks are fast, lasting less than 100 milliseconds. They appear suddenly, and involve abrupt movements that are suddenly interrupted. They are usually simple, although it is also possible that there is some complex.
On the other hand, tonic tics are the longest. They can last up to 500 milliseconds, and appear slowly. Often the movements they produce are more leisurely, generally involving several muscle groups.
Finally, halfway through we can find the dystonics. These are ticks that last between 100 and 300 milliseconds; and are characterized by producing sustained postures or movements, which are caused by a sudden contraction.
Nervous tics often occur in the area of the face. Due to this, another possible classification is the one that divides them between facial and body. However, there is some debate as to whether those that occur on the neck or head belong to the first group or the second..
The main characteristic of nervous tics is that they are movements that do not appear voluntarily. Even so, they are not considered strictly involuntary either, since they often appear as a conscious response to an impulse that the person undergoes before performing the gesture or vocalization..
In this way, tics are usually said to be semi-voluntary. One of its most interesting characteristics is that it is possible to repress them for a time; but finally, the person has to give in to its impulse and carry out the movement or sound.
One of the symptoms that most clearly differentiate tics from other similar problems, such as compulsions, is precisely the appearance of this need prior to movement. Patients who suffer from it compare this sensation to the need to blink, yawn or sneeze.
These sensations are often described as a gradual increase in tension, which can only be released by making a particular gesture, movement, or sound. Due to this, on many occasions the tics increase in frequency when the person is stressed or is immersed in a complicated situation.
The key to understanding how tics is found in the premonitory sensations that accompany them. Generally, for each of these semi-voluntary movements a different impulse appears. Some examples are a sensation of having something in the eye that causes blinking, or a tension in the shoulders that causes the person to shrug them.
The more aware the person is of the foreboding sensation of their tics, the longer they are able to control them. Therefore, in situations where emotions are very high, or on the contrary the individual is very relaxed, tics often occur with a higher frequency. Also, children are less able to control them than adults.
However, despite the fact that it is possible to suppress tics for a certain time, individuals who suffer from them say that it is impossible for them to avoid them forever. After a certain period of time, it is necessary for them to release the tension by making a characteristic gesture or sound.
When studying the causes of nervous tics, it is necessary to distinguish between two types: those that are part of a psychiatric disorder, and those that appear independently of any pathology.
There are some psychiatric illnesses that cause the appearance of both vocal and motor tics. Some of the most famous are Huntington's chorea, and Tourette's syndrome. In both cases, its exact origin is unknown; but it is known that they are closely related to genetic problems.
In many cases, these diseases appear together with other conditions such as attention deficit hyperactivity disorder (ADHD) or some compulsive-type pathologies, such as OCD. However, these two types of psychological problems do not have to always occur at the same time..
In any case, when nervous tics appear as a consequence of one of these diseases, the differential diagnosis will be different than in cases in which they occur in isolation. Because of this, the treatments are also different, focusing more on trying to solve the underlying problem as much as possible..
Unlike the nervous tics related to diseases such as Tourette syndrome, no single genetic or psychological cause has been found to explain the appearance of those that do not have to do with a pathology. However, the problem is believed to arise at the brain level.
Today, we know that certain problems related to this organ can cause tics to appear in people who have never suffered from them. Thus, for example, the fact of being subjected to brain surgery, having a stroke or having a serious infection can be the cause of this symptom.
On the other hand, even in cases where there has not been a specific problem in the brain, it is believed that nervous tics have to do with the malfunction of this organ. Some research suggests that they arise due to an imbalance in some neurotransmitters, such as glutamate, serotonin or dopamine.
However, what we do not know today is why these brain differences are caused. Some researchers believe that they would occur due to genetic factors, while others believe that they would have more to do with the early experiences of the person. It is very likely that both factors are involved to some extent.
Nervous tics are not usually considered a serious problem for a number of reasons. On the one hand, despite being annoying, they generally do not interfere with the proper development of the person's daily life. In addition, they usually do not appear frequently, and they tend to remit spontaneously over time..
However, in cases where the tics occur in a very common and violent way, and significantly interfere with the person's life, it is possible to carry out some treatments that are relatively effective in reducing symptoms. The best known options are psychological therapy, and medication.
We have already seen that one of the characteristics that most differentiate nervous tics from other similar problems is that before the appearance of each one, the person can feel a kind of tension building up in some part of their body. This feeling is the key when it comes to psychological treatment for this problem..
It is impossible to completely eliminate tics through psychological therapy. On the contrary, this approach focuses on helping the individual to identify the premonitory sensations that precede them, and either to suppress them for as long as possible, or to carry out some alternative behavior that is less intrusive than that normally carried out.
In this way, although tics cannot be completely eliminated, the person learns to manage them in such a way that they can lead a more normal life despite them. Some of the most effective therapies in this regard are habit reversal therapy, and exposure and response prevention (ERP)..
In very extreme cases, in which the appearance of nervous tics significantly interferes with the person's daily life, it is possible to administer various medications to the patient that attack either the cause of this problem or its most annoying symptoms..
The medication can be used either as a complement to other types of therapy, or in isolation, depending on the needs of each patient. In addition, depending on the type of tics that the person has, and if other associated symptoms appear, the specific treatment will change from one case to another..
For example, if a patient's tics are related to excessive muscle tension, the most common drug treatment will be relaxing. In other cases, in which it is certain that the tics are caused by a neurotransmitter mismatch, psychotropic drugs may be administered.
In addition to this, in cases where the patient experiences great anxiety or discomfort due to the presence of their tics, it may also be indicated to give them medications that reduce these symptoms and help them lead a more normal daily life..
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