I believe that many otolaryngologists and ophthalmologists often have the encounter that many children often come to the clinic with involuntary dry cough, wrinkled nose, squeezed eyes, sighing and other symptoms, but often with rhinitis, pharyngitis, conjunctivitis or as allergic diseases after repeated treatment but never cured, or often recurring. Long-term heavy medication and medication changes have caused considerable impact on the growth and development of children. What is this all about? In fact, this is transient tic disorder in children —– is often first seen with ENT or ophthalmology because of early muscle twitching of the face or voice twitching, which is essentially a neurological disorder. The disease has the following characteristics: 1. hyperactivity, but not ADHD, just high energy. 2. twitching, predominantly facial, often squeezing eyes, wrinkling nose, dry cough, etc. 3. obscene speech syndrome at a later stage. So early and correct diagnosis is very crucial. Parents are often very nervous and attached to the child, often over-questioning or stopping the child, which we call “behavioral reinforcement”, and have the experience of multiple visits. 2. The tics are regular, often disappearing during play, interactive activities, sleep, dry coughing, blinking, etc., and reappearing when the child is idle or does not like to do something. 3. Facial symptoms can appear simultaneously or one by one, often as bad habits. 4. All examinations are generally normal, there are no organic lesions, and the child is generally in good physical condition. Ophthalmologists say “conjunctivitis”; ENT doctors say “rhinitis” and “pharyngitis”; internal medicine doctors say “bronchitis”. “Bronchitis”. However, the multidisciplinary treatment and repeated medication were ineffective. So what kind of disease is transient tic disorder in children? Transient tic disorder is a psychological (mental) disorder that is caused by a sudden contraction of a group of muscles causing purposeless twitching, fast and involuntary movements, and frequent repetition. There are three reasons: (1) the original protective action (such as conjunctivitis, eye foreign body caused by blinking, pharyngitis caused by the sound of phlegm), later become habitual action, (2) due to imitation of other people’s acquired action, (3) due to mental stimulation, psychological stress, in order to vent the tension and caused. Transient tic disorder is most common in children between the ages of 4 and 10, and is more common in boys. There are various types of twitching, such as eyelid muscle twitching leading to eye squeezing, teeth baring, laryngeal muscle twitching leading to phlegm sound, neck and limb muscle twitching leading to head shaking, head nodding, neck twisting, arm shaking, leg shaking, etc. Therefore, it is often first seen in ophthalmology and ENT department. So as an ENT ophthalmologist, and how should the parents of children treat this disease? We should do the following: 1. ease the parents’ tension, do not pay too much attention to and repeatedly remind the child of the tics, and adopt “behavioral weakness” treatment for the tics, i.e., do not ask too much about the concern or simply let them restrain, as studies have shown that loose interactive communication helps to weaken the tics. 2. The first physician should be aware of the disease, or at least be able to direct the child’s parents to the correct neurology department. Otherwise, simple treatment with “conjunctivitis”, “pharyngitis”, or “rhinitis” will not be effective, and over time, the tics will remain in a habitual manner and must be controlled with It is necessary to use psychotropic drugs to control the symptoms. 3. In the early stage, the main treatment is “behavioral weakness”, supplemented by short and medium-term oral treatment with glutamate + vitamin B1. Haloperidol, Tebretol, Benadryl, etc. In short, the disease requires communication, communication and awareness among doctors, parents and children in order to effectively diagnose and treat a mental illness. Only by treating the “patient” can the doctor effectively treat the “disease”.