Tics in Children

Tics are stereotypical, involuntary, sudden-onset, purposeless and compulsive movements of different intensity. Th ey are the most common form of involuntary movements in children, with the prevalence of 299 cases per 10,000 school-age population aged 13-14 years. Morphologically, tics may be classified into simple motor tics, complex motor tics, auditory/acoustic motor tics, and sensory tics. Secondary, or symptomatic, tics are caused by an organic disorder of the nervous system and occur much less frequently than primary ticks, which do not result from an organic disorder. Tics may be associated with psychiatric disorders, cognitive impairments, sensory defi cits, dyslexia, dysgraphia, dyscalculia, attention deficit hyperactivity disorder, somnambulism, pavor nocturnus, nightmares, and enuresis nocturna. Children with tics are more prone to depression, anxiety, inadequate sexual behavior and antisocial defiant behavior. Haloperidol, risperidone and pimozide are available for the treatment of severe tics. The polymorphism of expression, association with psychiatric and other pediatric disorders, and varied treatment and its limitations make childhood tics a great challenge for clinicians. Researchers will still have to clarify the pathophysiology and find new treatment options for tics. Clinically, tics require a team work between neurologists, psychologist, psychiatrists and clinical pharmacologists.