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Facial tics

Definition

A facial tic is a repeated spasm, often involving the eyes and muscles of the face.

Alternative Names

Tic - facial; Mimic spasm

Causes, incidence, and risk factors

Tics most often occur in children, but may last into adulthood in some cases. Tics occur three to four times as often in boys as girls. Tics may affect as many as one-fourth of all children at some time.

The cause of tics is unknown, but stress appears to make tics more severe.

Short-lived tics (transient tic disorder) are common in childhood.

A chronic motor tic disorder also exists. It may last for years. This form is very rare compared to the common short-lived childhood tic. Tourette syndrome is a separate condition in which tics are a major symptom.

Symptoms

Tics may involve repeated, uncontrolled spasm-like muscle movements, such as:

Eye blinking
Grimacing
Mouth twitching
Nose wrinkling
Squinting

Repeated throat clearing or grunting may also be present.

Signs and tests

The health care provider will usually diagnose a tic during a physical examination. No special tests are needed. In rare cases an EEG may be done to look for seizures, which can be the source of tics.

Treatment

Short-lived childhood tics are not treated. Calling the child's attention to a tic may make it worse or cause it to continue. A non-stressful environment can make tics occur less often, and help them go away more quickly. Stress reduction programs may also be helpful.

If tics severely affect a person's life, medicines may help control them.

Expectations (prognosis)

Simple childhood tics should go away on their own over a period of months. Chronic tics may continue for a longer period of time.

Complications

In most cases, there are no complications.

Calling your health care provider

Call for an appointment with your health care provider if tics:

Affect many muscle groups
Are persistent
Are severe

Prevention

Many cases cannot be prevented. Reducing stress may be helpful. Sometimes counseling can help your child learn how to cope with stress.

References

Franklin SA, Walther MR, Woods DW. Behavioral interventions for tic disorders. Psychiatr Clin N Am. 2010;33:641-655.

Jankovic J, Lang AE. Movement disorders. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 21.

Ross AH, Elston JS, Marion MH, Malhotra R. Review and update of involuntary facial movement disorders presenting in the ophthalmological setting. Surv Ophthalmol. 2011;56(1):54–67.

Ryan CA, Gosselin GJ, DeMaso DR. Habit and tic disorders. In: Kliegman RM, Stanton BF, St. Geme JW III, et al., eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 22.

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