Can’t stop blinking and nodding at you? It could be a facial tic disorder ……

  Tic disorder is a rapid and repeated muscle contraction that causes involuntary physical activity and articulation, mostly in childhood. Patients can sometimes have short controlled seizure-free episodes, which can be exacerbated by situations such as stress, pressure or the use of special drugs. Tic disorders can manifest as simple actions such as blinking, frowning, nodding, shrugging, clearing the throat, coughing, etc., or as complex actions such as organizing appearance and imitating others.  The cause of tic disorder is still unknown, and studies have shown that the disorder is associated with genetics and other factors, while boys are more likely to develop the disorder than girls. As adolescence ends, most patients experience a complete remission of tic episodes. In patients with a similar family history, the tics may persist.  Patients with tic disorders are often associated with psychiatric disorders such as ADHD and obsessive-compulsive-impulsive disorder, as well as with the effects of anxiety, depression, and learning difficulties.  For patients with mild and non-impaired functioning, no medication is required and cognitive-behavioral therapy and family therapy can be administered directly. For patients with significant tic disorder that affects daily life, medication can be administered in addition to cognitive-behavioral therapy and family therapy. For patients whose twitching involves the whole body or complex seizures, medications such as butorphanolamide, fluphenazine, and risperidone can be considered.  For patients with focal twitches, especially those involving the face and neck or phonation, local injections of botulinum toxin may be considered. In a Canadian clinical study, botulinum toxin injections were shown to reduce the frequency of twitching episodes and reduce the desire for twitching episodes. The American Academy of Neurology, in its Review of Botulinum Toxin Treatment, also suggests that botulinum toxin injections may be effective for tic disorders.  As research on tic disorders continues, it is now believed that deep brain stimulation (DBS) may be considered for patients with refractory tic disorders.