Transient Tic Disorder
Short-lived involuntary movements or sounds in childhood
Quick Facts
- Type: Neurological (movement) condition
- Tic type: Motor, vocal, or both
- Duration: Less than one year
- Outlook: Usually resolves on its own
Overview
Transient tic disorder, now often called provisional tic disorder, is a common childhood condition in which a child has one or more tics, sudden, repetitive, involuntary movements or sounds, that last for less than a year. It is the most common tic disorder in children and is usually mild.
Tics in this disorder may be motor (such as eye blinking or shoulder shrugging), vocal (such as throat clearing or sniffing), or a mix of both. They tend to wax and wane and often disappear on their own within weeks to months. Because the tics are short-lived, reassurance and a calm, supportive approach are usually all that is needed.
Symptoms
The main feature is the presence of tics that have lasted less than a year. These may include:
- Motor tics such as eye blinking, facial grimacing, head jerking, or shoulder shrugging
- Vocal tics such as throat clearing, sniffing, grunting, or humming
- Tics that come and go and change over time
- An urge or sensation before the tic that is relieved by performing it
- Tics that increase with stress, excitement, or tiredness
By definition, the tics in transient tic disorder have been present for less than a year. If tics persist beyond a year, the diagnosis may change to a chronic tic disorder or Tourette syndrome.
Causes
The exact cause is not fully understood, but tics are thought to involve differences in the brain circuits that control movement. Contributing factors include:
- Genetics: A family history of tics increases the likelihood.
- Brain development: Tics often appear as the brain matures during childhood.
- Brain chemistry: Differences in pathways involving the basal ganglia and chemical messengers are thought to play a role.
Tics are involuntary and are not caused by bad behavior, poor parenting, or anxiety, although stress and excitement can make them temporarily more noticeable.
Risk Factors
- A family history of tics or Tourette syndrome
- Being a young child, as onset is most common between about 5 and 10 years of age
- Being male, as tics are more common in boys
- Periods of high stress or excitement
Diagnosis
The diagnosis is made by observing the tics and reviewing the history. A doctor will:
- Confirm that tics have been present for less than a year
- Confirm that tics began before age 18
- Rule out other medical causes or medications that can cause similar movements or sounds
Because the tics are short-lived, a period of observation often clarifies whether the condition is transient or developing into a longer-lasting tic disorder. Tests are usually not needed unless other symptoms suggest a different cause.
Treatment
Most children with transient tic disorder need no specific treatment, since the tics usually fade on their own.
- Reassurance and education: Explaining that the tics are common, involuntary, and usually temporary reduces worry for the child and family.
- A supportive approach: Avoiding drawing attention to or punishing tics helps reduce stress that can worsen them.
- Behavioral therapy: If tics are bothersome, techniques such as Comprehensive Behavioral Intervention for Tics (CBIT) can help, though this is more often used for longer-lasting tics.
- Managing stress and sleep: Ensuring adequate rest and reducing stress can lessen how often tics appear.
Medication is rarely needed for transient tics.
Prevention
- Tics cannot be prevented, but a calm environment can reduce their impact
- Ensure enough sleep and reduce sources of stress
- Avoid drawing negative attention to the tics
- Reassure the child that tics are common and usually pass
When to See a Doctor
See a doctor if a child develops new tics that you want evaluated, especially if they last more than a few weeks, interfere with daily activities, or cause distress. Seek prompt evaluation if tics appear suddenly and severely, are accompanied by other new neurological symptoms, or follow a new medication, so that other causes can be ruled out.
Frequently Asked Questions
What is transient tic disorder?
It is a common childhood condition in which a child has motor or vocal tics that last less than a year. The tics are usually mild and tend to fade on their own.
Will the tics go away?
In most children, transient tics resolve within weeks to months. If tics last longer than a year, the diagnosis may change to a chronic tic disorder or Tourette syndrome.
Should I tell my child to stop the tics?
No. Tics are involuntary, and asking a child to stop or punishing them can increase stress and make tics worse. A calm, supportive approach that avoids drawing attention to the tics is best.
Do transient tics need treatment?
Usually not. Most children need only reassurance and a supportive environment. Behavioral therapy or other treatment is considered only if the tics are bothersome or persist.
Can stress cause tics?
Stress does not cause tics, but it can make existing tics more frequent or noticeable. Excitement and tiredness can have the same effect, while calm, restful periods often reduce them.
References
- Centers for Disease Control and Prevention (CDC). Tourette Syndrome and Tic Disorders.
- National Institute of Neurological Disorders and Stroke (NINDS). Tics.
- MedlinePlus, U.S. National Library of Medicine. Tics.
- American Academy of Pediatrics. Tics and tic disorders in children.