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Chronic Motor Tic Disorder

What Is Chronic Motor Tic Disorder?

Chronic motor tic disorder is a condition that involves 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.

Chronic motor tic disorder is more common than Tourette syndrome, but less common than transient tic disorder. This is a temporary and self-limited condition expressed by tics. Another type is dystonic tics, which appear as abrupt bursts of movements followed by a sustained contraction.

Chronic motor tic disorder begins before the age of 18, and typically resolves within four to six years. Treatment can help lessen its effect on school or work life.

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Causes

What Causes Chronic Motor Tic Disorder?

Doctors aren’t entirely sure what causes motor tic disorder or why some children develop it earlier than others. Some think chronic motor tic disorder may be the result of physical or chemical abnormalities in the brain.

Neurotransmitters are chemicals that transmit signals throughout the brain. They may be misfiring or not communicating correctly. This causes the same “message” to be sent over and over again. The result is a physical tic.

Risk Factors

Who Is at Risk for Chronic Motor Tic Disorder?

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

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Symptoms

Recognizing the Symptoms of Chronic Motor Tic Disorder

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

Some people have strange bodily sensations before a tic occurs. They’re usually able to restrain their symptoms for short periods of time, but this takes effort. Giving into a tic brings a sense of relief.

Tics may be made worse by:

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

Diagnosis

Diagnosing Chronic Motor Tic Disorders

Tics are typically diagnosed during a regular office appointment. Two of the following requirements must be met in order for you or your child to receive a chronic motor tic disorder diagnosis:

  • 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 tics must have started before the age of 18.

No test can diagnose the condition.

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Treatments

Treating a Chronic Motor Tic Disorder

The type of treatment you receive for chronic motor tic disorder will depend on the severity of the condition and how it affects your life.

Behavioral Therapy

Behavioral treatments can help a child learn to restrain a tic for a short period of time. According to a 2010 study published in the Journal of the American Medical Association, a treatment approach called comprehensive behavioral intervention for tics (CBIT) significantly improved symptoms in children. 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 tics. Dopamine blockers are frequently used to control tics. They include:

Side effects can be serious and include movement disorders and blunted thinking (e.g., sedation, confusion, or paranoia).

Other Medical Treatments

Injections of botulinum toxin (commonly known as “Botox” injections) can treat some dystonic tics. Some people find relief with electrode implantations in the brain.

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Outlook

What Can Be Expected in the Long Term?

Children who develop chronic motor tic disorder between ages 6 and 8 usually recover. Their symptoms typically stop without treatment in four to six years.

Children who develop the condition when they’re older and continue to experience symptoms in their 20s may not outgrow the tic disorder. In those cases, it may become a lifelong condition.

Article Resources
  • Chronic motor tic disorder. (2012, February 6). The National Institutes of Health. Retrieved July 19, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001753/
  • Chronic motor tic disorder – Overview. (2010, March 21). University of Maryland Medical Center. Retrieved July 19, 2012, from http://www.umm.edu/ency/article/000745.htm
  • Chronic tic disorder. (n.d.). Perelman School of Medicine - University of Pennsylvania. Retrieved July 20, 2012, from http://www.med.upenn.edu/ctsa/tic_symptoms.html
  • Placentini, J., Woods, D., Scahill, L., Peterson, A., Chang, S., Ginsburg, G., et al. (2010). Behavior therapy for children with Tourette disorder: a randomized controlled trial..Journal of the American Medical Association,303(19), 1929-1937. Retrieved August 16, 2012, from http://www.ncbi.nlm.nih.gov/pubmed/20483969
  • The Tourette Syndrome Classification Study Group. (1993). Definitions and classification of tic disorders. Archives of Neurology,50(10), 1013-1016. Retrieved August 16, 2012, from http://www.tsa-usa.org/aMedical/definitions.html 
  • Chronic tic disorder. (n.d.).Retrieved from http://www.med.upenn.edu/ctsa/tic_symptoms.html
  • Diagnosing tic disorders. (n.d.). Retrieved from http://www.cdc.gov/ncbddd/tourette/diagnosis.html
  • Definitions and classification of tic disorders. (1993). Arch Neurol., 50(10), 1013-1016. Retrieved from http://archneur.jamanetwork.com/article.aspx?articleid=592549
  • Mills, S. & Hedderly, H. (2014, January). A Guide to Childhood Motor Stereotypies [sic], Tic Disorders and the Tourette Spectrum for the Primary Care Practitioner. Ulster Medical Journal, 83(1), 22-30. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3992090/
  • Placentini, J., Woods, D., Scahill, L., Peterson, A., Chang, S., Ginsburg, G., Deckersbach, T., Dziura, J., Levi-Pearl, S., Walkup, J. T. (2010). Behavior therapy for children with Tourette disorder: a randomized controlled trial. Journal of the American Medical Association, 303(19), 1929-1937. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=185896  
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