Blink blink blink = tic tic tic

The Pediatric Insider

© 2009 Roy Benaroch, MD

Mark’s frustrated. His son has gone through several months when he seems to blink a lot—then it goes away, then it comes back later. It doesn’t seem to bother the boy. One doctor said it was allergies, and prescribed an eye drop; another one says it’s a compulsion, and that dad should ignore it. What’s going on here?

Most likely, he’s got a tic. Not a tick—that’s a blood sucking beetle-looking thing—but a tic, which is a quick, short involuntary muscle movement. The most common tics seen in kids are blinking, followed by throat clearing; sometimes kids have a little quick facial grimace or a neck-turn.

You’ve got the wiring for a tic, too. Let’s watch yours. Go ahead, stop blinking. I’ll wait here. Dum dee dah dum. Still not blinking, right? It’s getting hard….hard to not blink…have to concentrate…so, do any fishing lately? no? ….wait …no blinky….wait….arrrgh blink blink blink blink blink blink. Aaaaaaa. That’s better.

What happened? Believe me, your eyes didn’t dry out that quickly. So why did you feel an urge to blink?

That’s basically what a tic is. It’s an involuntary movement—you can’t put it off, you’ve just got to do it. If you don’t, it gets harder and harder to stop it…until…blink blink blink! Blinking, in all of us, is like a helpful tic, an automatic mechanism to keep your eyes healthy. But sometimes that mechanism causes excessive blinking, or other sorts of quick involuntary movements that can’t be suppressed.

About 1 in 20 of us has a tic, and tics usually start to develop in early childhood. Usually, the individual tic goes away after a few months. But children who’ve had a tic in the past are quite likely, even after several months or years, to once again develop a tic, often a different one.

Do not tell a person with a tic to stop it. If he tries, the tic will become harder and harder to resist, until it returns in a more exaggerated fashion. The best therapy? Don’t talk about it.

Tics do get worse with emotional upset, anxiety, or tiredness. They stop completely when you fall asleep. Many people blame incessant throat clearing on “allergies”—but oddly enough, when they sleep, there’s no need for throat clearing at all. You’d think lying down would just encourage a nice pool of mucus, wouldn’t you? So why is there no need to clear the throat during sleep? Most throat clearers aren’t allergic—they’ve got a tic. But their minds “invent” the feeling of phlegm and the allergy story. Amazing, the mind, what it will come up with.

Most children with tics have only one, and it goes away on its own after a few months. No treatment is needed. Rarely, children develop multiple complex motor and vocal tics, often associated with difficulty concentrating at school. This is Tourette’s Syndrome—more serious, but far more rare than an ordinary tic. If your child has multiple tics and especially if school is becoming a problem, see a pediatric neurologist. Medicines are almost never necessary for simple, non-bothersome tics, but for the rare child with more serious tic issues medication can be very helpful.

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19 Comments on “Blink blink blink = tic tic tic”

  1. The Wife Says:

    Sounds like this might be what was going on with that 12 year old girl who couldn’t stop “sneezing”. It didn’t seem like an actual sneeze as it came from her mouth instead of her nose, and her eyes didn’t close when she would sneeze. Hope hers has gone away!

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  2. Dr. Roy Says:

    Exactly! When I saw that video, it was obvious to me that she has a tic– especially because the “sneezes” end completely when she sleeps. Besides, as you say, they really didn’t look like sneezes.

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  3. Allison Says:

    Dr. Roy,

    As a mom with a son with Tourettes (well, tic disorder official diagnosis — should be Tourettes but I haven’t brought him back to the neurologist! LOL!) that no one notices but me, your advice is spot on, as usual. Tics are best ignored.

    Thanks!!

    Allison

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  4. Dr. Roy, thank you so much for this post on tics. Both of my boys have Tourettes and I am eager to get more information out there as to what Tourettes and tics are really about as most people do not understand it!

    Like

  5. Cindy Says:

    I noticed that my 6 year old son has been blinking and moving head up and down uncontrollably. I have not noticed it before today . What should I do? I thought he was purposely doing it, but now I realize he cannot control it.

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  6. Dr. Roy Says:

    Cindy, if this started all at once today and is as dramatic as it sounds, you ought to take him in to see his physician. This may be a simple tic like the ones I wrote about, but it sounds more sudden and severe than is typical. He ought to be evaluated.

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  7. Sandra Riggs Says:

    Thank you for this post. I really, really wish you were a network provider with Tricare. I would love to have you work with my children as so many rave about your on target advice and medical care. For now, I guess I will just have to learn from your posts!

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  8. Lyneve Says:

    My 9 yr old son blinks his eyes, clears his throat and moves his nose from side to side. it only started with the blinking eyes. He has been diagnosed with ADHD and ODD and has been moved from Ritalin to Concerta 36mg. Am i being paranoid? i dont want this to affect his self confidence when he gets teased, and it must annoy him too, although it seems at times he doesnt even know he is doing it. please advise???

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  9. Dr. Roy Says:

    Lyneve, it sounds like your son has tics. Children with tics do not know they’re doing it, and usually it doesn’t bother them.

    Though medications like Concerta and Ritalin (which actually contain the same active ingredient) can make tics worse, they don’t trigger tics.

    You ought to discuss your concerns with your son’s doctor.

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  10. Paige Says:

    Hello , I have severe excessive blinking I have had it for over 7 years, it’s now got so bad that I close my eyes for periods of time, it’s so frustrating, what medication could I take , please help

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  11. Dr. Roy Says:

    Paige, please go see a doctor to discuss your concerns. There are medicines (and other interventions) that can help. Best of luck!

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  12. itsasecret Says:

    i have this thing where my eyes kind of do quite a long and a bit hard blink (compared to usual blinks) and a girl in my class commented on it today. i cant stop. i do suffer from OCD as well… i have always had these things that i do. when i was seven, whenever there would be a full stop if i was writing down that conversation with anyone i would say in my head “CUT”!! and slice my hand down. i mannaged to reduce it gradually myself without telling anyone but this tic i cant stop. i do really well at school, and a+’s are frequent so i cant think that its because i cant concentrate… i do stress and just before a test recently i had an anxiety attack when i wouldnt breathe and i was shaking alot. i would really like some advice maybe to stop this stupid thing before it becomes very intensive. I dont want any medicaton, though, im only twelve.

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  13. LisaMarie Says:

    My five year old son started his first tic at 3 1/2 with excessive eye blinking and has had 6 more different tics in the past year and a half…sniffing, throat clearing, squeak noise from throat, eye brow grimacing, neck stretching and the current moving his head back in forth..he’s starting to get very bothered by these movements as his friends are asking “why” he’s doing it..he really has not had any rest period in the past 3-4 months…each tic would last a month or so and go right into the next tic…the current tic is the most frustrating for him and us because it’s interfering with his everyday activities. Our pediatrician just said he will outgrow these tics and no need to worry, but when our 5 year old son tells us he hates himself because he can’t stop..it’s heartbreaking…do we see a pediatric neurologist or just wait it out?

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  14. MGM Says:

    Hello, my 5year old kindergarten son has what I think may be a vocal tic. It started about 2 weeks ago & has been getting more frequent. He just continues to say “hm…..hm…..hm” the last couple of days it’s obvious that he can’t control it. I am taking him to the pediatric doctor tomorrow & requesting a refferal for a pediatric neurologist, possibly a blood test. I don’t know what else to do. It doesn’t seem to be interfering with school. I asked his teacher about it but she didn’t have anything to say about it other than she did notice it as well.

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  15. Coreen Says:

    Hi there,
    My 8 yr old son has developed involuntary muscle movements which start with his head and move down to his feet. It mostly involves his torso and arms. They are quick, almost rythymic movements. They occur while he is at rest, but will completely diasapeer while asleep. When he is very focused on something, I don’t see these movements or tics. He is starting to sit on his hands to stop it. Do you think this warrants a trip to a paediatrician? Or should I just ignore it? He is quite an anxious boy… Thank you!

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  16. Dr. Roy Says:

    Coreen, you ought to take your son to his doctor, and bring a video of the movement he’s making. Best of luck-

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  17. jon Says:

    Hey I’ve have a rapid blinking problem that comes once a year and its getting pretty annoying what should i do eye drops don’t help

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  18. Dr. Roy Says:

    Jon, go see an eye doctor.

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  19. Kara Says:

    My 9-year old son has long periods where he has no tics at all, but then he has periods (like now) where he has a few different simple tics: clearing his throat, widening his eyes and/ or waving his hand over his plate while he eats. None at the same time but all consistent. He said to me this evening, “Mommy, I am getting that weird feeling in my throat and eyes again where I have to clear my throat and make my eyes wide.” Is it normal for a 9-year old to recognize he has tics? I try to ignore it but when he brings it up I am at a loss.

    Last year when his tics flared up, he had an EEG done, which was normal, and we took him to a pediatric neurologist, who diagnosed him with transient tic disorder. He had a solid six months of minimal to no tics but now they are starting up again, with much more recognition on his part. I’ll be calling the neurologist tomorrow, but advice is welcome!

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