In this lecture, we are going to discuss
Tics and also Tourettes in children.
are involuntary repetitive
They are purposeless.
They are just a movement that moves
for no particular no good reason.
And they can be very simple,
they can be fairly complex.
Tourettes Syndrome is a Tics disorder
that is specific to children and
adults who have the condition.
This is defined as multiple motor tics.
and at least one vocal tic.
And typically this vocal tics and motor
tics are not necessarily simultaneous.
So, tics which are incredibly common
especially on boys
can be defined as simple or complex.
Let's go through this.
Simple tics will be things like blinking,
perhaps a shoulder shrug
or a head jerk
or simply clearing of
The clearing of the throat one though is also
very common in adults.
Complex tics on the other hand,
which are less common
may include a brief period of
The patient may kick or jump.
They can be really unusual body
or patients may develop unusual
Coprolalia is when patients say swear words
Echolalia is when they repeat words
that are just said to them.
And Palilalia is when patients repeat
their own words over and over again.
So, tics are common
occur and primarily at an onset of around
6 or 7 years of age.
They are much more common in boys.
Rarely, they arise from previous
such as brain damage.
And they are usually worse when the patient
is stressed out.
They can be surpressed for a brief
periods of time.
a patient with a tic disorder can
control them under a certain circumstance.
But then need to suddenly relieve them.
I have a patient once with Copalalia
who can control his Copolalia while he
is in a classroom.
but would literally need
to run outside and relieve
is copolalia in private.
They may persist even during sleep.
And so, that is how we can distinguish
between tics and other behavior.
They can also wax and wane and
change over time.
Typically boys with simple tics
may even change what their tic is
over several months
and then eventually ease off
tics trouble caregivers or
far more than they trouble
the child with the tic.
And that's actually key.
A child generally is not truly bothered
by their problem.
So, in terms of management of
generally management is supportive.
Because most of the time
these resolve on their own,
There is not too much that we
Usually, tics resolve in less than a year
especially the transient types
happening in these young boys.
And 2/3 of the children will have complete
resolution of their tics.
However, some tic disorders are more
permanent such as Tourettes.
90 percent of patients with Tourettes will
also have another co-morbidity.
These includes things like Attention Deficit
Obssessive Compuslive Disease
or learning disabilities.
For these patients with more severe tics,
we can manage them with medications.
These are rarely indicated.
These are limited to cases that
or interfere with activity.
Haloperinol is an example
of drug that we use or pimozide.
Both of these drugs can be used
help to control tics.
Side effects of tic medications
can be severe.
Side effects may include
cardiac conduction problems
anticholinergic side effects such
as dry mouth
Bone marrow suppression and Esophageal
They may develop dystonia
They can develop neuroleptic
And this can cause excessive sedation.
That is all I have for you today
about tics and tics disorders in children.
Thanks for your children.