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Transient Tic Disorder (Provisional Tic Disorder)

What is transient tic disorder?

Transient tic disorder, now known as provisional tic disorder, is a condition involving physical and verbal tics. The Diagnostic and Statistical Manual, 5th Edition (DSM-5) renamed this disorder in 2013. A tic is an abrupt, uncontrollable movement or sound that deviates from a person’s normal gestures. For example, a person with tics may blink rapidly and repeatedly, even if nothing is irritating their eyes.

Every person experiences tics differently. They may suffer from either uncontrolled movements or noises. Tics are common in children and may last for less than one year. A child with transient tic disorder has noticeable physical or vocal tics. The American Academy of Child and Adolescent Psychiatry states that tics affect up to 10 percent of children during their early school years.

The most notable tic disorder is Tourette syndrome, in which both physical and verbal tics occur in the same individual, often at the same time. Transient tic disorder also involves both types of tics, but they often occur individually.

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Causes

What causes transient tic disorder?

There is no known cause of transient tic disorder. Like Tourette syndrome and other tic disorders, a combination of factors influences it.

Some research indicates that tic disorders may be inherited. A genetic mutation can cause Tourette syndrome in rare cases.

Abnormalities in the brain may also be responsible for tic disorders. Such abnormalities are the cause of other mental conditions, such as depression and attention deficit hyperactivity disorder (ADHD).

Some research suggests that transient tic disorder could be linked to neurotransmitters. Neurotransmitters are the chemicals in the brain that transmit nerve signals to your cells. However, no studies offer complete proof of the role neurotransmitters play. Medications to treat transient tic disorder alter neurotransmitter levels.

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Symptoms

What are the symptoms of transient tic disorder?

Tic disorders include Tourette syndrome, chronic motor or vocal tic disorder, and transient tic disorder. Your doctor may diagnose your tic disorder as nonspecific if your symptoms don’t fall exactly into one of those categories.

Tics are often confused with nervous behavior. They intensify during periods of stress and don’t happen during sleep. Tics occur repeatedly, but they don’t usually have a rhythm.

People with tics may uncontrollably raise their eyebrows, shrug their shoulders, flare their nostrils, or clench their fists. These are physical tics. Sometimes a tic can cause you to repeatedly clear your throat, click your tongue, or make a certain noise, such as a grunt or a moan.

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Diagnosis

How is transient tic disorder diagnosed?

There is no foolproof test to diagnose transient tic disorder and other tic disorders. They are difficult to diagnose, as tics are sometimes associated with other conditions. For example, allergies might be a cause for a repeated sniffing or twitching of the nose.

If you have tics, your doctor will begin your medical evaluation by performing a physical exam (especially a neurological exam) and complete medical history. This will help to rule out an underlying medical condition as the cause of your symptoms.

Your doctor may need to order other tests, such as brain CT scans and blood tests, to determine if the tics are a symptom of something more serious, such as Huntington disease.

You must meet all the following conditions to receive a transient tic disorder diagnosis:

  • You must have one or more motor tics (such as blinking or shrugging your shoulders) or vocal tics (such as humming, clearing your throat, or yelling a word or phrase).
  • Tics must occur for less than 12 months in a row.
  • Tics must start before 18 years of age.
  • Symptoms must not be a result of medication or drugs, or of another medical condition such as Huntington disease or post-viral encephalitis.
  • You must not have Tourette syndrome or any other chronic motor or vocal tic disorder.
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Treatment

How is transient tic disorder treated?

Transient tic disorder in children often goes away without treatment. It’s important that family members and teachers don’t call attention to the tics. This can make the child more self-conscious and aggravate their symptoms.

A combination of therapy and medication may help in situations where the tics affect work or school. Because stress can make tics worse or more frequent, techniques to control and manage stress are important.

Cognitive behavioral therapy is also a useful way to treat tic disorders. During these sessions, a person learns to avoid self-destructive actions by controlling their emotions, behaviors, and thoughts.

Medication can’t completely cure tic disorders, but it can reduce symptoms for some people. Your doctor may prescribe a drug that reduces the dopamine in your brain, such as fluphenazine, haloperidol, or pimozide (Orap). Dopamine is a neurotransmitter that may influence tics.

Your doctor could also treat your tic disorder with antidepressants. These drugs help treat symptoms of anxiety, sadness, or obsessive-compulsive disorder, and may help with the complications of transient tic disorder.

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Outlook

What is the long-term outlook?

Living with transient tic disorder can be frustrating at times. However, the condition is manageable with proper treatment. Try to keep your stress at reasonable levels to help reduce your symptoms. Therapy and medication can help relieve symptoms in some cases.

Parents of children with transient tic disorder play an important role in providing emotional support and helping ensure that their child’s education doesn’t suffer.

Typically, tics disappear after a few months. Research seems to indicate that children experiencing tics who had none over a year ago have a favorable outlook. However, these children have only about a one in three chance of remaining completely tic-free over the next 5 to 10 years.

Parents should keep a watchful eye on changing symptoms regardless. In some cases, transient tic disorder can develop into a more serious condition, such as Tourette syndrome.

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