© 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.
The Pediatric Insider 
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