Nervous tic causes and. Nervous tic

Any nervous tick associated with a violation in the work of muscle groups, but the disease can be reflected in different parts of the human body. Tics are associated with disorders in the work of the central nervous system, which manifest themselves under the influence of various factors. Pathology in one way or another affected at least once in the life of every person. But there are forms of nervous tics that literally interfere with people's lives.

Violation usually manifests itself after a child or adult is exposed to a traumatic, stressful factor. If such factors act on the body constantly, chronic changes occur in it, and tics acquire generalized forms. Neurologists are involved in the treatment of the disorder.

Nervous tics are more often found in children, as their nervous system is unstable and breaks down faster under stress. However, the causes of the disorder in adults and children are often the same. They are primary and secondary.

The primary most often include constant stressful situations and emotional experiences up to severe shocks. Phobias, sensibility and severe anxiety can also cause a violation.

It has been noticed that pathology appears more often in children with hyperactivity syndrome, as well as in those who are prone to neuroses.

Common causes for children and adults are nervous and emotional exhaustion, when the nervous system has to work hard. Chronic fatigue syndrome used to be diagnosed only in adults, now this disease is “younger”, it is often found in children aged 14-17 years. It is much easier to treat tic syndromes if they are caused by mental or emotional overload - it is enough to eliminate the traumatic factor.

More complex disorders are secondary nervous tics characteristic of severe diseases:

• cysts, tumors and neoplasms in the brain that occur against the background of compression of the trigeminal, facial or auditory nerve;
• vegetative-vascular dystonia;
• brain diseases, including meningitis, encephalitis, hydrocephalus;
• trigeminal neuralgia;
• poisoning, especially carbon monoxide;
• injuries received during childbirth;
• mental disorders: autism, schizophrenia, manic depression.

In children, a nervous tic can persist as a response, a habit, after an illness. So, if a child has been ill with mumps, which makes it difficult to swallow and causes severe pain in the neck, in the future he may continue to twitch in the direction where there was soreness.

Among hereditary disorders, special attention is drawn to Tourette's syndrome, which is characterized by pronounced tics of the face, body, as well as vocal disorders.

Suddenly, the syndrome cannot appear only if there have been similar incidents in the family's medical history. The development of pathology is triggered by an autoimmune disorder, or a poor environmental situation. Some patients are deficient in magnesium and B vitamins.

Types of neurological disorder

In the understanding of a person, a nervous tic is most often associated with a violation of blinking - the eyes and eyelids twitch. However, there are other forms of the disorder, including mixed ones, in which the nervous tic extends to the entire body or most of it:

• Mimic tics. The most common form, developing in the face, rarely moving to the upper neck. In patients, the muscles of the eyelids, lips, and other facial wrinkles twitch. The most common association is with motor tics.
• Engine tick. Muscle contraction occurs involuntarily and affects larger parts of the body: arms, legs, shoulder girdle. Severe motor disturbances are accompanied not only by muscle twitches, but also by involuntary movements, such as waving the arms.
• . With vocal tics, disturbances are severe and mild. So, in mild forms of a nervous tic, involuntary sounds are observed: whistling, snorting, wheezing, pronunciation of individual letters. Severe forms may be accompanied by shouting out whole words or phrases, as well as their cyclical repetition. In Tourette's syndrome, the patient yells out swear words.
• Touch tick. The disorder is associated with altered perception of cold, heat and other sensations by patients.

Another interesting form of classification of nervous tics is by complexity. Simple disorders are associated with the development of mild scenarios that rarely affect more than 2 muscle groups. Complex scenarios are associated with a certain sequence of manifestations that occur one after another in different muscle groups.

Symptoms of various disorders

From the classification, it usually becomes clear how this or that nervous tic manifests itself:

• The mimic appearance of a neurological deviation is due to the fact that when a person is excited, his lips, eyelids, eyebrows, and other facial muscles begin to twitch.
• The motor deviation is accompanied by slight muscle twitches, but can progress to more severe symptoms with uncontrolled movements of the arms and legs. For example, patients may twist their elbows or hands, snap their fingers, or tap their feet.
• Voice deviations are accompanied by a loud cry of words or sounds. In most cases, vocal tics are associated with motor tics, accompanied by twitching of the head, upper body, or waving of the arms.
• Sensory deviations appear suddenly, regardless of the action of external factors. A person sharply feels itching in a certain area, or severe cold or heat, as well as movements associated with goosebumps.

For all nervous tics, a multiple increase in the period of experiences and stress is characteristic.

Diagnosis of neurological abnormalities

At the appointment with a neurologist, the patient will be asked questions about when the nervous tic first appeared, how long it usually lasts, which symptoms are more pronounced. Be sure to collect an anamnesis of diseases and try to find out the apparent cause of the violation.

If no exact factors for the development of the deviation are found, additional examinations are prescribed: blood tests to rule out infections and other diseases, CT and MRI, as well as X-rays to identify physiological factors of the disorder.

Electroencephalography is prescribed to determine the conductivity of nerve fibers, as well as to study the activity of the brain. Additionally, in the treatment of tics, it may be necessary to consult an oncologist, a traumatologist and a psychotherapist (psychiatrist).

Ways to treat the disorder

Different methods are used to treat a nervous tic, but first you need to pay attention to lifestyle. So, if the pathology is caused by psychological or emotional tension, the rules of therapy are as follows:

• be sure to eliminate the factor that provokes a nervous tic: problems in the family, at school, in interpersonal relationships;
• it is necessary to strictly normalize the regime of the day so that there is no lack of sleep;
• the help of a psychotherapist is needed - the doctor will help to cope with stress and other irritating factors that increase the nervous tic.

An important place in the treatment of tics is occupied by medications - they are prescribed by a doctor in order to relax muscles, eliminate tension and stress. These can be both mild herbal preparations, most often used for therapy in children, and potent tranquilizers, indicated for the treatment of nervous tics in advanced cases.

Medications for disorders

Among the most effective sedatives that are safe for adults and children are:

• Valerian infusion. Esters of the natural root improve the functioning of the nervous system, soothe, relieve irritation and have a positive effect on the functioning of the heart. You need to take courses for 3-4 weeks as prescribed by the doctor.

• Motherwort tincture. It has a more powerful calming effect on nervous tics than valerian. Improves heart function, slightly reduces blood pressure and helps digestion.
• Diazepam ("Sibazon", "Diazepex" and other drugs with the active substance). A mild sleeping pill prescribed strictly by doctor's prescription. Used to eliminate violations of moderate severity. It relieves anxiety, eliminates insomnia, and normalizes the mental state.

• Phenazepam. A strong tranquilizer for the treatment of severe nervous tics. Helps to cope with seizures, severe anxiety, muscle spasms and insomnia.
• "Haloperidol". A psychotropic drug for treatment in cases where even potent tranquilizers do not help. Completely suppresses motor excitation and has an analgesic effect.

• "Pimozide". Psychotropic drug, analogue of drug No. 5. Has a longer lasting effect.

Before taking any strong medication, you need to find out why a nervous tic occurs. If the cause is not eliminated, then even after a course of medications such as phenazepam, there will be no effectiveness.

Treatment of hereditary forms of tics

For the treatment of nervous tics of a hereditary nature, potent substances are almost always used. One of the most commonly used drugs is "Haloperidol". Also appointed "Cyclodol", which helps to get rid of trembling in the limbs, relaxes the muscles, while improving their motor activity.

Important! Powerful psychotropic drugs from the sulpiride group are taken in courses to eliminate mental disorders and depression that occur against the background of tics.

Also, in severe cases, Pimozide therapy is prescribed, which still remains one of the most effective drugs.

Treatment of secondary abnormalities

If it is established that nervous tics appear due to the action of an internal cause - a disease, then it is necessary to prescribe treatment for the provoking factor:

• complex antibiotic therapy for viruses and infections;
• operations for cysts, tumors and other structural disorders;
• insulin therapy for diabetes;
• means for blood flow in case of circulatory disorders in the brain;
• if mental illness is detected, psychotropic substances must be used;
• with VVD, vitamins and adaptogens, nootropics and other drugs that normalize brain activity are prescribed.

You can not do without a physiological effect, which has a good effect on the psychological, emotional and physical condition of the patient, who is worried about the nervous tic.

Relaxing treatments - the basis of therapy

It is very useful to undergo massage courses when a nervous deviation is detected. Usually, relaxing procedures are prescribed, focused on the collar zone. Acupuncture is very effective - needles are injected into active points, which has a positive effect on relaxation, improving blood flow.

No less effective is acupressure without the use of needles - during the procedure, the therapist presses on the active points, activating positive processes. It is very useful to visit the bath in the absence of contraindications, as well as stone therapy.

Folk recipes

Many folk remedies have a calming effect and are characterized by increased safety regarding drugs. The most effective soothing and strengthening teas:

• blooming Sally;
• chamomile;
• black tea with mint;
• a tea made from a mixture of plantain, lemon peel, anise seeds, rue grass and honey.

You can make compresses on the places of muscle contraction, using honey diluted in pure water, as well as infusions of chamomile and wormwood.

Prevention

If nervous tics haunt the patient constantly, but there are no secondary reasons for their development, the rules for the prevention of neurological disorders must be strictly observed:

• it is necessary to change the environment - work, relationships within the family;
• be sure to normalize night sleep - at least 7 hours, if this is not enough, increase to 8-9;
• do not use computers, tablets and phones 2 hours before bedtime;
• carry out aromatherapy procedures with pine or fir esters before going to bed;
• take baths with decoctions of chamomile or fir 1 hour before bedtime.

Patients with nervous tics have a positive effect on moderate exercise and walking in quiet places.

The appearance of a nervous tic should always alert a person, because in most cases this sign indicates an unfavorable environment around. If secondary causes in the form of diseases of internal organs are excluded, it is necessary to normalize mental and emotional well-being.

Tic hyperkinesis (nervous tics) are sudden, jerky, repetitive, violent, involuntary movements, covering various muscle groups. It is a common neuropsychiatric disorder in adults and is especially common in children. Tics are characterized by a lack of rhythm, vary in intensity, and can be partially controlled (temporarily suppressed by volitional effort). Due to the uniformity of tick movements, they can be imitated relatively easily. Such convulsive erratic contractions can occur in different muscle groups (motor tics) in different parts of the body, and often the vocal apparatus (vocal tics) is involved in the pathological process.

Among the motor tics, the most common twitching of the cheek, eye (nervous tic of the eye), rhythmic shaking of the head, frequent blinking / raising the eyebrows, shoulders, retraction of the abdomen (nervous tic in the abdomen), squats, dancing. Vocal tics are more often manifested by coughing, "sniffing" nose, noisy breathing, "grunting".

In frequency, in decreasing order from the upper body to the lower, there are tics of the upper part of the face (blinking, raising the eyebrows), then tics of the lower part of the face (twitching of the cheeks, lips), then - raising the neck / shoulders, tics of the trunk and limbs. In many cases, several tics are noted. Tics, as a rule, are aggravated under the influence of emotional manifestations (embarrassment, anxiety, fear). At the same time, their severity decreases during intense concentration of attention, entertainment, sexual arousal, after taking alcohol. The course of tic hyperkinesis is undulating with periods of exacerbation and temporary remission. There is a hereditary (family) predisposition.

In ICD-10, tic disorders are classified as emotional and behavioral disorders, usually beginning in childhood/adolescence, and are a borderline neuropsychiatric pathology. Often, tics increase as puberty approaches, and remission of tic manifestations is noted with age. In addition, adults control tics more effectively than children and many can suppress them within minutes. It must be said that the intellectual capabilities of persons with tic hyperkinesis for the most part do not suffer.

The relevance of the problem of tic disorders is due to disappointing statistics, according to which tic in various forms occurs in 1-3% of adults and in almost 20% of children / adolescents. At the same time, boys suffer from tic disorders 3-4 times more often than girls. Approximately 3-4% of patients have a chronic tic disorder and Tourette's disorder about 1%.

Nervous tics, especially in cases of stigmatizing contractions of several muscle groups at the same time or from vocalizations, can lead to pronounced social maladjustment and cause a serious impact on the formation of the child's personality and his psychological development. Persons with such disorders (especially children) may experience constant psychological discomfort due to the inadequate reaction of others (they become objects of bullying / ridicule). The most severe manifestation of this pathology is Tourette's syndrome (generalized tic), in which there are behavioral disorders in the form of obsessive-compulsive syndrome, often leading to persistent social maladaptation and even disability.

Pathogenesis

To date, there is no single point of view on the pathogenesis of tic hyperkinesis. There are several concepts for the development of the disease:

• Concept of oxidative stress disorder with lack of activity/deficiency superoxide dismutase , which contributes to the accumulation of free radicals and leads (under conditions of low antioxidant protection) to changes in receptors and disruption of neurotransmission in the cells of the motor-sensory cortex and in the caudate nucleus.
• Infectious-autoimmune theory, based on which the pathological process is triggered by an infectious factor (respiratory viruses, streptococci).
• Genetic disorders of the mechanism of synaptic transmission, gamma-aminobutyric acid due to accumulation from generation to generation of gene expression.
• The theory of dysfunction of the temporo-frontal cortex of the left hemisphere of the brain.
• Concept fright paradigms due to mental overload, emotional stress factors that cause a violation of the stereotype of behavior.
• The concept of neurotransmitter heterogeneity of tic diseases, according to which motor tics are caused by impaired dopamine metabolism, and serotonin metabolic disorders are more associated with vocal tics.

In general, it is generally accepted that tic disorders occur under the complex action of genetic, psychological, neurobiological and environmental factors. It is based on violations of dopaminergic/serotonergic neurotransmission and regulatory mechanisms in the cortico-striatal-thalamocortical system, which, according to most authors, is responsible for the occurrence of tics. It is the excessive density of dopamine receptors and disturbances in the basal ganglia of dopamine neurotransmission that lead to a decrease in subcortical inhibition and disorders of automatic movement control, the appearance of excessive, uncontrolled movements, clinically manifested by motor/vocal tics.

Classification

There are several types of classification of nervous tics, which are based on various factors. According to the etiological factor, there are:

• Primary (hereditary tic diseases, including Tourette's syndrome).
• Secondary (organic). The leading risk factors for which are prematurity , in pregnant women, fetal hypotrophy , mother's age over 30 years, birth trauma, previous brain injury.
• Cryptogenic (etiology unknown).

Topico-clinical manifestations:

• local - tics in one muscle group (mainly facial);
• common - tics are noted in more than 2 muscle groups;
• generalized (Tourette's syndrome) in combination with vocal tics.

With the flow:

• Transient course - characterized by complete reversibility of hyperkinesis.
• Remittent course - proceeding with exacerbations of the disease lasting from 2 months to a year, which alternate with remissions, lasting from 2-3 weeks to 2-3 months.
• Stationary course - is determined by the presence of persistent hyperkinesis in various muscle groups that persist for 2–3 years.
• Progressive course - characterized by an increase in symptoms in the absence of periods of remission.

Causes of a nervous tic

Tic occurs due to the influence of a variety of factors: genetic abnormalities, infections, injuries, organic brain damage, intoxication, degenerative processes. In clinical neurology, according to etiological factors, several types of hyperkinesis are distinguished:

• Primary. They are of residual organic origin. They develop as a result of idiopathic degenerative processes in the structures of the brain and, as a rule, are hereditary.
• Secondary. Appear against the background of non-rough residual-organic changes in the central nervous system and peripheral nervous system ( neuropathy ). Often they are a manifestation of the underlying pathology due to toxic damage (CO2 poisoning,), traumatic brain injury, infection (, rheumatism ), a brain tumor, a hemodynamic disorder of brain structures ( encephalopathy ) or be a side effect of the use of certain drugs (psychostimulants, antipsychotics, MAO inhibitors, in cases of an overdose of dopaminergic drugs).
• Psychogenic. Caused by chronic / acute psycho-traumatic deeply experienced impact (disadaptation in school and preschool institutions, prolonged work on the computer, uncontrolled TV viewing, separation from one of the parents, conflicts in the family, hospitalization), various mental disorders (, generalized anxiety disorder , ).

Factors that provoke tics:

• Stressful situations (fright, being in school / kindergarten, watching horror films).
• Traumatic brain injury.
• Deficiency in the diet of trace elements and vitamins (group B and magnesium).
• Acute / chronic respiratory viral, streptococcal infection.
• Chronic overwork (mental overload, long sessions on a personal computer).

As an example, below is a diagram of the main causes of nervous tic of the eye, according to the data of statistical processing of examination materials of children.

The main factors provoking eye tics in children

Symptoms of a nervous tic

In most cases, tic symptoms are characterized by significant polymorphism in terms of localization, intensity and frequency, involvement of muscle groups, generalization of tics.

The main symptom of a tic disorder is spontaneously occurring involuntary muscle contractions that are difficult to consciously control. Clinical symptoms depend directly on the localization of the muscles in which the nervous tic develops. Symptoms of a nervous tic most often appear after mental overwork, a sudden psychotraumatic situation, as a result of quarrels and conflicts.

Nervous tic, localized in the area of ​​the mimic muscles of the face, is more often manifested by frequent blinking, intense movement of the lips, movements of the corner of the mouth, chaotic movements of the eyebrows, twitching of the wings of the nose, frowning of the forehead, opening / closing of the mouth.

Types of motor tics localized in the facial muscles of the face

Hyperkinesias in the head/neck region involving skeletal muscles, as a rule, are manifested by impulsive nodding of the head and its mechanical turns. When deployed on the body, reflex contractions of the abdominal muscles, pelvic muscles, and chaotic movements of the diaphragm are noted. When localized on the limbs, mechanical clapping of hands, stomping / light squats or bouncing in place are observed.

Symptoms of a vocal tic in a child/adult are manifested by coughing, unconscious utterance of syllables/incoherent sounds, "sniffing" nose, barking cough, noisy breathing, "hunting".

Clinically, there are several types of motor tics:

• Local tic, which captures one muscle group, mainly mimic muscles, manifested by rapid blinking, squinting, movements of the wings of the nose, corner of the mouth, cheeks.
• A common tic, in which several muscle groups are involved in the pathological process at the same time - the muscles of the face, neck, head, shoulder girdle, upper limbs, abdominal and back muscles in the form of tilts / turns of the head with tilting it back, frequent blinking and looking up, head turns and induction of gaze, induction of gaze and twitching of the shoulder, in the form of movements of the shoulder back, upwards and bending of the arms in the elbow joints, bending of the arms and others. The most characteristic are the combination of persistent facial tics with hyperkinesis of the shoulder girdle.

The process of transition of motor tics from the face to the muscles of the neck/shoulder girdle usually takes about 1-3 years. Patients adapted to single-series hyperkinesis are able to participate in the educational process, however, with an exacerbation of the disease, shoulder movements and frequent head turns make it difficult for the school learning process.

Vocal tics include:

• Simple isolated vocalisms (grunting, noisy breathing, whistling, grunting, choking / clearing the throat), which can also be single, serial and status. As a rule, they intensify after overwork and negative emotions. In most cases, they disappear after a few weeks and have a favorable prognosis.
• Complex vocal tics. Occurs predominantly in patients with Tourette syndrome . They are characterized echolalia (repetition of words), pronunciation of individual words, palilalia (fast slurred speech) swearing (coprolalia). echolalia refers to non-permanent symptoms and may appear and disappear periodically, coprolalia in the form of serial uttering of curses is a status condition and limits the social activity of the child, making it impossible to visit public places.

Their combination is quite common, when vocal manifestations are attached to motor tics. This option is less favorable. Below is a table of the most common clinical variants of motor/vocal tics.

Most common clinical variants of motor/vocal tics

The severity of the clinical course is determined by the number of hyperkinesis for a certain period of time. With single ticks, their number varies from 2 to 9/20 minutes, with serial ones - within 10-30, after which there are many-hour breaks and status ones with the number of ticks in the range of 30 - 200/20 minutes, following without a break for day.

Also, it should be taken into account that about 60% of children/adolescents with chronic motor/vocal tics have one or more comorbid mental disorders. At the same time, the likelihood of developing comorbid disorders increases with the early onset of tic symptoms, the severity of manifestations, and the presence of a burdened family history.

Major psychiatric disorders in children/adolescents with tic disorders

Tourette syndrome

Tourette's syndrome ("multiple tic disease") is the most severe form of hyperkinesis in children. It is clinically manifested by motor and vocal tics against the background of attention deficit disorder and obsessive-compulsive disorder. It is inherited in an autosomal dominant manner, while in boys tics are combined mainly with hyperactivity and attention deficit disorder, and in girls - mainly with obsessive-compulsive disorder.

The clinical picture is largely determined by the age of the patient. The disease debuts more often in 3-7 years. Initially, a local nervous tic appears in the child on the face and twitching of the shoulders, which then capture the upper / lower limbs and are manifested by shudders and turns / tilting of the head, flexion / extension of the hand and fingers, contractions of the abdominal muscles, squats and bouncing. In this case, one type of ticks is replaced by another. Often, motor tics (for several years after the debut) are accompanied by vocal tics, which sharply increase in the acute stage. And vice versa, in some cases, vocalisms appear first, and later they are joined by motor hyperkinesis.

Generalization of tic hyperkinesis most often increases gradually over a period of several months to 3-4 years, reaching a peak at 8-11 years. It manifests itself clinically as a series of hyperkinesias or frequently recurring hyperkinetic statuses, combined with autoaggression and ritual actions. A pronounced hyperkinetic syndrome in children (a state of increased arousal) is characteristic, manifested by excessive mobility, severe restlessness, impaired attention and ability to concentrate, and a lack of response to the comments of others. They practically do not respond to comments. Difficulties in falling asleep are often observed.

Despite the fact that this syndrome is called hyperkinetic, hyperkinesia , most likely, is a defect (deficit) of attention, which persists as the child grows. At the same time, in adolescence, hyperactivity can be replaced by a decrease in activity, a lack of motivation and inertia of mental activity. However, it is important, according to Dr. Komarovsky, to differentiate hyperkinesia from a simple state of anxiety, including motor anxiety, which is characteristic of many children at this age. The key features that allow for differentiation are the relationship with severe attention disorders and the child's ability to mentally concentrate.

It is important to distinguish between hyperkinetic syndrome in children and hyperkinetic cardiac syndrome, which refers to one of the manifestations of dysfunction of the autonomic nervous system for which muscle spasticity is not typical. Unlike hyperkinesia, this syndrome refers to functional disorders and occurs mainly in young men aged 16-20.

With a series of hyperkinesis, there is often a change in motor tics with vocal ones and the appearance of ritual movements. At the same time, patients feel discomfort/pain from various excessive movements (pain in the cervical spine against the background of frequent head turns). In some cases, there is also a risk of injury, for example, when the head is thrown back in combination with simultaneous clonic twitching of the limbs (the child can hit the back of the head against the wall).

Status tics in duration can last from 1-2 days to 1-2 weeks. In some cases, exclusively motor or vocal tics are present ( coprolalia ). At the same time, despite the uncontrollability of tics, consciousness in children does not suffer. During the period of exacerbations, children cannot attend school and preschool institutions, self-service is difficult.

Most often, exacerbations of the disease lasting from 2 months to a year alternate with remissions (from 15-21 days to 2-3 months). In the future, in most children at the age of 12–15 years, hyperkinesis passes into a residual phase, which is manifested by local and widespread tics. Approximately 30% of children with Tourette's syndrome in the residual stage (without the presence of obsessive-compulsive disorders) have a complete cessation of tics.

Analyzes and diagnostics

The diagnosis is made on the basis of a detailed medical history from the birth of the child/adult. To obtain information about the presence of comorbid disorders, specific standardized questionnaires can be used. A physical / neurological examination is performed, including. If necessary, additional examinations are carried out: electromyography (recording of electromyograms of muscles involved in tic symptoms), computed tomography of the brain. Mandatory differential diagnosis, which allows to exclude other diseases that occur with similar symptoms.

Nervous tic treatment

The treatment of nervous tics is a complex and lengthy process, including a set of measures - regime moments, psychotherapeutic effects, psychopharmacotherapy, biofeedback. There is no single ready-made scheme for the treatment of tics. It should be said that getting rid of a nervous tic, taking into account various pathogenetic mechanisms, the presence of basic / additional symptoms, is an extremely difficult task. It should also be noted that there are no separate methods for treating tics, depending on their location or types of tics (motor/vocal tics). Therefore, the questions “how to cure a nervous tic of the eye in adults”, “how to treat it, how to get rid of eye twitching, how to remove a tic from the eye” or “what is the treatment of a nervous tic of the eye” should be considered from the perspective of general therapy of tic hyperkinesis.

It is also important to take into account the fact that the treatment of tics in adults and the treatment of nervous tics in children do not fundamentally differ, with the exception of methods of psychological influence (in children, mainly in the form of games), dosages and forms of drugs. The main goal of treatment is the social adaptation of the child/adult and the minimization of tic symptoms. First of all, regime restrictions are needed to minimize the impact of negative stimuli: limiting TV viewing, computer work (especially computer games), which sharply increase the bioelectrical activity of the brain, compliance with the work / rest schedule, creating a benevolent atmosphere for the child in the family without focusing on ticks , creating conditions for a good night's sleep. Often, even when the psychotraumatic factors are smoothed out or the child is removed from the psychotraumatic environment, the tics disappear. It is also important to create emotionally significant hobbies and interests in the child. Sports are especially effective.

The next important direction in the treatment of ticosis is the psychotherapeutic effect. There are many psycho-corrective methods. Some of them are aimed directly at the patient (cognitive-behavioral psychotherapy, habit reversal therapy, hypnosis, and others), and some are aimed at correcting the psychological situation in the family, which involves reducing the requirements for the child and minimizing stress/conflict situations.

Medical treatment

The therapeutic strategy is to achieve the optimal balance between the maximum possible control of tic symptoms and the minimum side effects. Tics should not be expected to disappear completely, and symptoms should be expected to improve.

Drug treatment should be prescribed only for severe, persistent, pronounced tics, combined with gross behavioral disorders, complicating his adaptation in the team, poor school performance or affecting the child's well-being. In cases where tics do not affect the normal activity of the child, but only parents are concerned, drug therapy should not be prescribed. Some experts, in particular Dr. Komarovsky, in one of the programs “Komarovsky on the treatment of nervous tics in children”, believes that it is necessary to resort to drug therapy only in extreme cases. Parents should not panic when a child has tics, and even more so focus the child's attention on this. Calmness and following the recommendations of the doctor will help to cope with the problem. Keep in mind that about 60% of children with tics go away as they get older. It is important to create a good psychological environment in the family. The main thing in the treatment of tic disorders in children is the unconditional love of loved ones and time for them.

In the pharmacotherapy of tics, a stepwise principle is important, according to which the most mildly acting drugs with a minimum of side effects are first prescribed. Then, if necessary, they gradually switch to more effective drugs, the appointment of which is often accompanied by side effects. Therefore, they should first be administered in small doses with a gradual increase.

Traditionally, nootropic drugs, anxiolytics and neuroleptics are used in the treatment of tics. Of the group of nootropics, derivatives are the most widely used. gamma-aminobutyric acid , in particular tablets , Pyritinol , the mechanism of action of which is due to a direct effect on the GABAB-receptor-channel complex.

Antipsychotics. From this group can be appointed, Aripiprazole , pimozide , Fluphenazine . This group of drugs has antipsychotic, antiemetic, anticonvulsant, analgesic, antipsychotic and sedative effects. The mechanisms of their action are based on the blockade of the hypothalamus, dopaminergic postsynaptic receptors of the limbic system, the gag reflex zone, the extrapyramidal system, inhibition of the dopamine reuptake process, blockade of adrenoreceptors of the reticular formation of the brain. However, despite their rather high efficiency, which reaches 80%, they have frequent side effects in the form of,

Every healthy person is able to control his movements, that is, he can, at will, slow down or speed up the movements of the limbs, change their amplitude and direction of movement. However, the situation changes dramatically if various disorders of the nervous system appear. In particular, if the process affects the area that regulates, then involuntary movements appear. Consider the main movement disorders associated with this process.

Which is made up of the central (brain and spinal cord) and peripheral (nerves, nerve processes and endings) systems, regulates all processes occurring in the human body. Violations in its work are manifested by a variety of pathologies affecting both the work of internal organs and systems, and higher nervous activity. This is due to the fact that the nervous system is extremely branched, and each of its parts is unique. Often one of the nervous system are movement disorders, including involuntary movements. As a rule, the most common of them are the following:

• tremor (trembling) - is an involuntary, rhythmic vibration of a part of the body (most often it is the head or hands);
• hyperkinesis - enhanced muscle movements that differ from tremors in greater amplitude;
• myoclonus - sharp, sudden involuntary contractions of muscle groups (startle) that capture the entire body, its upper part or arms.

Essential tremor

This type of tremor is one of the most common forms of involuntary movements. It can manifest itself both in youth and in old age. Often the hereditary factor becomes decisive. This type of involuntary movement is a postural tremor that appears when you change the position of first one hand, then two. It can intensify to the point that it interferes with writing, holding small objects in your hands. Most often this occurs with excitement and after drinking alcohol. The process can involve the head, chin, tongue, as well as the torso and legs. Most often, however, essential tremor is hand tremor. Treatment is not required in most cases. If the tremor is severe and interferes with the normal functioning of a person, as a rule, a neurologist prescribes beta-blockers. If excitement and anxiety are the provoking factor that causes hand trembling, treatment may include taking tranquilizers.

Parkinson's disease

Another common ailment, a sign of which is a pronounced violation of motor functions, is Parkinson's disease. is associated with the gradual death of brain neurons that produce dopamine (a mediator that regulates movement and According to statistics, every hundredth person who has passed the sixty-year mark is affected by this disease. Men get sick more often than women. The causes of the disease have not been studied in detail. For a person with such a diagnosis , like Parkinson's disease, treatment, unfortunately, is symptomatic and does not guarantee recovery.

As a rule, the first symptoms of the disease often go unnoticed. As development progresses, there is a decrease in manual dexterity, facial expressions grow thin, and a mask-like face appears. Involuntary movements of the head are also observed, speech is disturbed, the ability to control one's movements. Slow walking can be replaced by an uncontrollable run, which the patient is not able to stop on his own. In the future, the imbalance and problems with walking intensify.

Treatment

With such an ailment as Parkinson's disease, treatment most often comes down to the use of drugs that slow down the development of the disease. That is why it is so important to identify it at an early stage. When the first symptoms appear, when there is a chance to slow down the destruction of brain neurons, it is necessary to seek the advice of a neurologist.

To date, the main drug that slows down the pathological process is Levodopa. It is used in conjunction with several other groups of drugs, but, unfortunately, can only slow down the development of the disease. However, active research is currently underway on the possibility of treating Parkinson's disease surgically - transplanting cells capable of producing dopamine into the patient.

Chorea

Another disease, a sign of which are hyperkinesias (uncontrolled movements), is chorea. In a broad sense, it can rather be called a symptom complex, since the causes that cause it can be very different. Chorea is manifested by involuntary waving movements of the limbs, head and trunk. The tongue and facial muscles may also be involved. Often these movements are compared with grimacing, dancing. It is characteristic that during sleep all symptoms completely disappear.

Causes of chorea

As already mentioned, involuntary movements in chorea can be caused by a number of unrelated causes. The most common factors are:

• heredity - with many hereditary genetic diseases, such as Konovalov-Wilson's disease, symptoms of chorea are observed;
• long-term use of drugs - these can be antipsychotics, antiemetics;
• infectious diseases - often involuntary movements in children (small chorea) occur after streptococcal tonsillitis;
• chronic insufficiency of cerebral blood supply;
• inflammatory brain (vasculitis);
• hormonal disorders (in particular, with insufficient function of the parathyroid glands).

Treatment for chorea depends on the underlying cause. This may be the treatment of the underlying disease, the abolition of the drug or a decrease in its dose if the cause is an overdose, as well as with cerebral palsy and insufficient blood supply to the brain. With chorea of ​​any etiology, B vitamins and drugs that improve nutrition and stimulate the brain (neurotrophics, nootropics) are used.

Myoclonus

Another involuntary movement is myoclonus. Most often, this phenomenon can be observed in yourself or those around you when falling asleep. It is also called "night tremors". As a rule, they are absolutely safe, but in some cases they are expressed to such an extent that sleep disturbance occurs. Most often this happens when a person is relaxed and ready to fall asleep. Muscle contractions can provoke noise or other external factors, while the process of falling asleep can be significantly disturbed. Sleep myoclonus usually does not require medical treatment.

The situation becomes much more serious if a person has myoclonic seizures or convulsions. As a rule, they are one of the signs of such a serious disease as epilepsy. A myclonic seizure can cause a fall, during which there is a high risk of fractures or head injury. The duration of the attack is 1-2 seconds, it starts abruptly and ends abruptly.

Myoclonic convulsions are more often manifested by muscle contractions in the arms. In the early stages, only the patient himself notes them, over time they worsen - a person drops objects, cannot hold them in his hands. Most often, such attacks are observed a few hours after waking up. In case of untimely referral to specialists, the process is generalized, and tonic-clonic convulsions and loss of consciousness join the convulsions in the limbs.

Hyperkinesia in children

Both adults and children can suffer from involuntary movements, while the latter are most characteristic of tic-like manifestations. Most often, this is expressed in brief repetitive contractions of individual groups of facial muscles. As a rule, such phenomena occur after overwork or excessive excitement of the child. Another common hyperkinesis in children is chorea. It is characterized by periodic twitching of the muscles of the head and shoulder girdle. The main reason is usually the child's stress, which may be an insignificant event from the point of view of an adult. That is why parents need to be attentive to the slightest manifestations of involuntary movements in their children.

As you can see, a healthy person is able to perform both voluntary and involuntary movements. However, if they begin to affect the quality of life, consultation with a neurologist is necessary.

Involuntary and uncontrolled muscle contractions, which are caused by false signals sent by the brain, are called hyperkinesis. An independent form of hyperkinesis is a tic disorder, also called a nervous tic or dyskinesia.

A nervous tic is manifested by a short-term manifestation of intense, rapid, stereotypical, involuntary contractions of muscle tissue. A nervous tic occurs independently of the will of the individual, the process of chaotic movements is not controlled and controlled by the human consciousness. Random spasmodic contractions can occur in any part of the body and can affect the vocal apparatus.

The development of a tic disorder is not associated with muscle dysfunction, but is initiated by significant malfunctions in the functioning of the brain. A nervous tic starts as a result of a significant damage to neurons and a violation of neuronal metabolism in certain segments of the brain.

The intensity of this type of hyperkinesis can be reduced by willpower and deliberate stimulation of certain nerve receptors. Symptoms of a nervous tic disappear with a change in body position and during a night's sleep.

Although a nervous tic does not threaten the life of an individual, this unpleasant disorder has an extremely negative effect on the psycho-emotional state of the individual, introduces significant difficulties in a person’s life, and acts as a huge obstacle to full-fledged social interaction. It is extremely important to treat the pathology in a timely manner, since a nervous tic gives rise to various complexes and can cause a conscious isolation of the individual from society.

Nervous tic: varieties

There are several different classifications of a nervous tic. This form of hyperkinesis is subdivided according to the following criteria.

According to the place of anatomical localization of the muscle group:

• facial nervous tic, otherwise referred to as mimic, is fixed on the entire surface of the head and neck;
• vocal nervous tic - contraction of the muscles of the vocal cords;
• nervous tic of the limbs - involuntary movements of the arms or legs;
• nervous tic of the torso is an unnatural process in the torso area.

By the size of the prevalence of pathology:

• local nervous tic is an abnormal phenomenon in which the tissues of one muscle group are involved.
• generalized nervous tic - convulsive contractions are determined in several groups of muscle fibers.

By the degree of complexity of the abbreviations produced:

• a stereotypical nervous tic implies the production of simple elementary contractions;
• multivariate nervous tic is characterized by complex and diverse contractions of the muscles.

By duration:

• transient form - lasting up to one year;
• chronic - observed for more than 12 months.

Nervous tic: causes

For etiological reasons, the origin of the nervous tic is conventionally divided into three categories.

The first type of anomaly is multiple motor nervous tic, officially called Gilles de la Tourette's syndrome.

The disease has a progressive genetically determined character. The exact cause of the development of Tourette's syndrome has not been established, however, in official medical circles, the version of unfavorable genetic inheritance combined with the negative influence of environmental factors has been accepted. A common cause of the manifestation and intensification of a nervous tic in Tourette's syndrome is autoimmune neuropsychiatric disorders. This disease almost always debuts in childhood, while by the time puberty is reached, the frequency and intensity of attacks decreases significantly, and by adulthood, in most cases, the disease disappears. At the same time, gender plays a significant role in the occurrence of tic disorder: a nervous tic due to a defective gene is more often detected in men.

The second type of pathology is the primary nervous tic, also called psychogenic, which directly reflects the cause of the disorder.

The onset of involuntary convulsive movements almost always coincides with or is a consequence of traumatic situation. Any chronic stressful condition or sudden tragedy, which the individual interprets as intense, significant, irresistible, can provoke a nervous tic. Despite the benign nature of this form of tic disorder, the anomaly introduces significant problems in the life of the subject, overcoming for years.

The third type of defect is a secondary nervous tic, which is called the symptomatic form of hyperkinesis.

The reason for the development of convulsive contractions of the muscles is an organic disease of the brain, a transferred dysmetabolic lesion of the central nervous system. Symptomatic nervous tic is often the result of:

• traumatic brain injury;
• acute cerebrovascular accident;
• inflammation of the brain - encephalitis;
• postencephalitic parkinsonism;
• toxic encephalopathy - the ingress of toxins into the blood as a result of carbon monoxide poisoning;
• intoxication of the body with an overdose of drugs, in particular: neuroleptics, stimulating psychotropic substances, drugs based on dihydroxyphenylalanine.

An objective factor that reveals the immediate cause of the development of a nervous tic is dysfunction of the frontal gyri, thalamus, and basal ganglia. Involved in the formation of tic disorders are failures in neural connections in some brain structures (cortical and subcortical segments).

Among other causes of a nervous tic, the following circumstances:

• lack of magnesium and subsequent metabolic failures;
• calcium deficiency or calcium metabolism disorders in endocrine pathologies;
• lack of glycine due to insufficient functionality of the thyroid gland;
• an excess of dopamine and catecholamines due to a malfunction in neurotransmitter metabolism in the extrapyramidal system of the brain;
• insufficient production of acetylcholine and serotonin due to disruption of neural connections in the strio-pallidar system.
• transferred acute respiratory viral infections with severe course;
• inflammatory processes in the organs of vision;
• excessive fatigue of the eyes due to their prolonged strain and non-compliance with occupational hygiene.

Nervous tick: symptoms

The leading symptom of tic disorder is the spontaneous occurrence of involuntary intractable muscle contractions. At the same time, the more persistently an individual tries to neutralize the manifestations of a nervous tic, the more intensely the muscle tissue contracts. Despite the impossibility of consciously controlling the work of the central nervous system, individuals are able, by volitional efforts, to delay the moment of crisis and ease the amplitude of muscle contractions.

Most often, the symptoms of a nervous tic appear after severe physical or mental overwork, as a result of a sudden psychotraumatic situation, after conflicts and quarrels. Symptoms of hyperkinesis increase gradually, while the manifestations of a nervous tic are outwardly visible to others.

The clinical symptoms of a tic disorder are directly dependent on the site where the tic develops.

• Hyperkinesis on the face is manifested by frequent blinking, chaotic movements of the eyebrows, shuddering of the nose, involuntary opening and closing of the mouth, intense movement of the lips, tension of the frontal area.
• A nervous tic, localized in the region of the head and neck, manifests itself with impulsive nods and mechanical turns of the head.
• In case of damage to the vocal apparatus, the following symptoms occur: unconscious pronunciation of incoherent sounds, individual syllables, the development of a barking cough, grunting or unintentional howling.
• If a nervous tic is located on the trunk, reflex movements of the abdominal muscles, chaotic movements of the diaphragm, and contractions of the pelvic muscles are observed.
• When the tic is localized on the limbs, the individual makes mechanical clapping with his hands, may stomp or bounce in place.

Nervous tick: treatment methods

It is extremely rare for the symptoms of a primary or secondary nervous tic to resolve on their own. In most cases, the manifestations of tic disorder become less pronounced after psychotherapeutic work and hypnosis sessions without medical treatment. The main task in the treatment of pathology is to normalize the mental status of the patient, to establish and eliminate the causes of the anomaly, to create a favorable atmosphere in the environment of the patient.

Medical treatment

Pharmacological treatment of secondary nervous tics and hyperkinesias in Tourette's syndrome is a rather difficult task. Drug treatment is carried out by a neurologist, choosing a therapy regimen taking into account the underlying pathology. Treatment of a secondary nervous tic involves two types of activities:

• etiotropic therapy - measures aimed directly at the elimination of the underlying disease;
• symptomatic therapy - the use of pharmaceuticals that work to eliminate muscle contractions.

In most cases, the following groups of drugs are used in the treatment of a nervous tic:

• dopamine receptor antagonists - neuroleptics, for example: haloperidol (Haloperidol);
• preparations based on valproic acid, for example: depakinchrono (Depakinechrono);
• tranquilizers of the benzodiazepine series, for example: phenazepam (Phenazepamum);
• derivatives of botulinum toxin, for example: dysport (Dysport).

Psychotherapy and hypnosis

It should be borne in mind that drug treatment does not guarantee the achievement of a long and stable remission if the true cause of the tic disorder has not been eliminated. Behavioral psychotherapy is necessarily included in the treatment of all types of nervous tics, the purpose of which is to minimize the degree of patient anxiety, teach relaxation skills, and help the individual develop confidence.

Hypnosis techniques provide real help in the treatment of psychogenic nervous tics. During a hypnotic session, the patient is in a state of natural trance. During trance, a person relaxes all muscle groups of the skeletal muscles, muscle spasms and clamps disappear, and nervous tension is eliminated. The semi-drowsy state contributes to the stabilization of the functioning of all organs, including the normalization of the functions of the central nervous system. Immersion in a hypnotic trance regulates cardiac activity, promotes measured breathing, and activates the recovery processes of the body.

Another advantage of hypnosis techniques is the possibility of direct access to the unconscious sphere, which is the repository of a person's life "script". Working with the subconscious allows you to identify the direct source of the development of a nervous tic, to eliminate the destructive components of the life program. Hypnosis treatment allows the patient to rethink the difficult moments of personal history in comfortable conditions, get rid of illogical fears, eliminate internal prohibitions and restrictions.

Treatment of a nervous tic with hypnosis- a real chance to defeat tic disorder without torturing your body with toxic products of the pharmaceutical industry. The advantage of treatment with the help of hypnosis is comfort, painlessness, atraumaticity, since all manipulations during the sessions are natural and harmless.

Audio recordings for the treatment of phobias and immersion in the ultra-deep stages of hypnosis.

“Tell me, please, where should I go from here?
- Where do you want to go? - answered the Cat.
- I don't care ... - said Alice.
“Then it doesn’t matter where you go,” said the Cat.
- ... just to get somewhere, - Alice explained.
“You’re bound to get somewhere,” said the Cat. “You just have to walk long enough.”

Somnambulism (deep stage of hypnosis) is such a mode of operation of the brain, in which all mental forces are subordinated to one idea or feeling. Amnesia (loss of memory) and hallucinations (with closed eyes) can be considered as the criterion for achieving this state.

• Audio recordings to reach the ultra-deep stages of hypnosis.

For therapeutic purposes, "somnambulism light" is usually used - the middle stage of hypnosis (two points according to Katkov, the level of eyelid catalepsy in Elman's induction), but even this level of immersion will require you to be brave. It will be necessary to get rid of everyday fears about hypnosis (“they will turn into zombies, break the psyche”) and think about why the two-century practice of using hypnosis in medicine has not led to the licensing of hypnotherapy? Having answered this question in yourself, think about the purpose of immersing yourself in somnambulism. Do you want to get rid of a psychosomatic illness or just experience the feeling of hypnotic nirvana? Both are good, but in the first case, one must be prepared for the fact that familiar symptoms will appear at some stage. Do you want to get rid of them? Then, while listening to the recording, you will not only have to put up with them, but also hold on to and even savor them. This is necessary so that the process of therapy begins in the free layers of the psyche that you have opened.

A nervous tic is a phenomenon that is more common in children. And with proper treatment or correction, it quickly disappears. However, there are adults who suffer from similar disorders. This disorder of nervous activity can manifest itself at almost any age.

What is a nervous tic

By the way, a nervous tic is a “relative” of such movement disorders as parkinsonism, chorea, myoclonus, and some others. All these are varieties of hyperkinesis, that is, involuntary movements in the muscles that occur according to an erroneous command of the brain.

What exactly is a nervous tic? This is a stereotyped, fast and involuntary elementary movement that occurs due to the contraction of one or more muscles. Such movements can occur in different parts of the body, including they can affect the vocal apparatus; in this case, a nervous tic manifests itself as an involuntary utterance of individual sounds, words, and even phrases.

Unlike chorea or myoclonus, nervous tics are not severe enough to interfere with normal motor activity. However, they create an unpleasant impression of the interlocutor and spoil their lives. Outwardly, nervous tics look like a caricature of normal movements, so they can sometimes cause laughter in others.

Even ancient physicians were interested in nervous tics. This phenomenon was first described in the seventh century, when it was called "the habit of muscles to contract."

What are nervous tics

The whole variety of nervous tics - and there are quite a lot of their types - had to be classified somehow. They are classified according to several criteria.

For example, according to localization, tics are divided into the following types:

• Mimic (facial);
• Voice (vocal), which are simple and complex;
• Respiratory (involving the respiratory muscles);
• Opercular (that is, chewing);
• Manual (combine the movements of the upper limbs);
• Focal (this includes movements of the head, face, torso and lower extremities).

In terms of prevalence, tics are local, when one muscle group is involved, and generalized, when different muscle groups are involved, which is why the tic resembles a purposeful movement.

By duration, they are temporary (last no more than a year) and chronic.

According to the complexity of nervous tics, there are simple (elementary movements) and complex (movements with a complex structure and the involvement of many muscles).

Mimic tics- this is twitching of the muscles of the face, grimaces. Twitching of the eye muscles deserves special attention, since such tics occur more often than others. The reason for this is that there are a huge number of muscles and nerve endings around the eyes; in addition, these are the weakest muscles of the human body. Another reason for the greatest prevalence of facial and especially eye tics is that the facial muscles move the most, because, in addition to their basic functions (control of the parts and organs of the face, eyes, jaws), they reflect the emotional experiences of a person.

Respiratory tics- coughing, grunting, noisy drawing in or out of air. Opercular - clattering, smacking, clicking teeth, champing. Manual tics - snapping fingers, rotating the hands, rubbing the palms, etc.

Simple voice tics- involuntary pronunciation of individual sounds. There are also complex vocal tics, in which there is an involuntary pronunciation of words and phrases; a variation of such a violation is, for example, coprolalia - an irresistible attraction to uttering obscene abuse, curses, ordinary insults, cynical remarks. Other examples are echolalia (painful repetition of words or their parts heard in someone else's speech), palilalia (painful attraction to the repetition of certain words and sentences).

Causes of tick development

The etiology of nervous tics is quite diverse. Tics are divided into primary, or psychogenic, and secondary, which are observed with organic or dysmetabolic damage to the brain, disruption of the internal organs, extrapyramidal disorders, due to the intake of certain antipsychotic drugs. There are even hereditary tics observed in the so-called Tourette's syndrome. With neuralgia, a painful tic may occur due to acute pain.

Special mention should be made of extrapyramidal disorders. In the cerebral cortex there are many nerve centers responsible for certain functions: speech, movements, emotions, visual images, thoughts. All these centers in the brain are closely intertwined. In the subcortical layer there is an extrapyramidal system, which is not part of the cortex, but is connected with it by numerous nerve connections. All these parts together form a single system that is responsible for coordinating the movements of different muscle groups, maintaining body posture, and regulating muscle tone. This is a very complex structure, and the slightest failure in it can lead to such disorders as nervous tics. Wrong command of the brain Wrong decoding of brain signals - these are the reasons leading to tics.

Tourette's syndrome is a genetic disease in which multiple motor tics and one voice tic are observed. Of the vocal, coprolalia occurs most often, much less often - echolalia and palilalia. In Tourette's syndrome, the tics are monotonous and non-rhythmic. They are usually preceded by some impulse; patients say that they feel tension in a certain part of the body, which they try to "relieve" with the help of movement. That is, tics in this case are, in a sense, conscious movements, although muscle tone still grows involuntarily. Such urges and urges are called sensory phenomena.

There are cases when Tourette's syndrome appeared sporadically, that is, it did not have a hereditary nature. It has also been shown that environmental and autoimmune factors play a certain role in the development of Tourette's syndrome and the degree of manifestation of tics. There are studies that have shown a certain dependence of the manifestation of tics on infection with streptococcal diseases.

For all types of tics, it has been established that males are most often affected than females.

A group of "touretteisms" is distinguished - conditions similar to Tourette's syndrome, but appearing for other reasons. Such causes can be stroke, encephalitis, traumatic brain injury and others.

Psychogenic causes of nervous tics are the most obvious. These are strong stresses, nervous strain, long-term mental work without a break. It has been noticed that tics are a frequent occurrence in children and adolescents during admission to kindergarten or school: these events in themselves are a certain stress for the child, especially since from this moment the intellectual load increases, the child has more demands than before.

Recently, scientists have made significant progress in the study of nervous tics. So, it was found that in half the cases, children with Tourette's syndrome also suffered from attention deficit hyperactivity disorder (ADHD). Perhaps this disease provokes the appearance of twitches.

How to recognize a nervous tic

Usually muscle twitches are visible to others. Moreover, it is not difficult to detect vocal tics. However, not every twitch or vocal act is pathological. In most people, individual cases of twitching of certain muscles, including the eyes, take place; this can happen from overwork, stress, a serious quarrel. Painful are twitches that occur constantly and without any external causes.

Often, patients seek to neutralize the growing tic by an effort of will. Some even succeed. However, in most cases, the strength of muscle tension only increases from this, and gradually the patient can no longer resist the attraction.

Manifestations of tics depend on their localization. These can be clapping hands, rubbing the palms, bouncing, stamping, moving the pelvis, buttocks, and abdominal muscles. Nervous tics localized on the face are expressed in twitching of the eyebrows, frequent blinking, shuddering of the nose, moving the lips. Tics localized in the head or neck area are manifested by involuntary nodding, turning the head in different directions.

It happens that patients are not aware of pathological muscle tension and do not complain about them; tics in this case are noticed by others. It has been observed that adults are more likely to be aware of their tics than young children.

The influence of external factors on tics is individual for each person. Often, when excited or with severe fatigue, pathological movements increase; but some people do the opposite. After drinking alcohol, the intensity of tics most often decreases, although the opposite also happens.

All nervous tics have one thing in common: the patient can hardly control them. Even if he is aware of their presence, they still occur against his will.

It should not be thought that nervous tics are associated with a serious lesion of the intellect or psyche. They, as a rule, do not interfere with normal mental activity, do not undermine the functioning of the nervous system. Tics appear in people of all ages, different levels of intelligence, different professions and with different social status.

As already mentioned, patients usually (if they are aware of the presence of a tick) begin to experience discomfort in the area of ​​localization of the disorder: growing tension in the muscles of the limbs, discomfort in the shoulders, "lump in the throat." After the “reset” of tension with the help of movement, relief or a pleasant sensation of itching occurs.

Diagnosis of twitches

To make a correct diagnosis, a nervous tic should be able to be distinguished from motor acts generated by other causes, including other types of hyperkinesis. Certain motor disorders can manifest themselves in Down syndrome, Klinefelter syndrome.

An electroencephalogram is prescribed when it is necessary to distinguish tics from convulsions. To exclude brain diseases, an MRI is prescribed. To "weed out" the possibility of hypothyroidism, measure the amount of thyroid-stimulating hormone in the body.

If nervous tics debut suddenly in adolescents or adults, a urine test may be prescribed to possibly detect traces of narcotic substances: in certain cases, it can also provoke the appearance of tics.

It is important to take an anamnesis, as well as interview family members of the patient. In the latter case, for example, studying the condition of the liver in a patient and relatives helps to exclude Wilson's disease. In certain cases, it is also necessary to examine the patient's feces and blood: motor disorders can be caused by helminths or infectious diseases.

How to get rid of a nervous tic

Like any neuropsychiatric disorder, tics can be cured with medication, psychotherapy, and specific exercises.

If the patient notes spontaneous muscle twitches in a certain area (which are called tics), then he can greatly strain this muscle. Such a simple procedure can eliminate the manifestation of the disorder for a while, since the muscle will be exhausted and will not be able to contract. However, this method does not eliminate the cause of the disease, and soon the twitching returns. This method cannot be used if the twitches are due to damage to the trigeminal nerve. In this case, it is recommended to avoid any irritating factors as much as possible - in particular, avoid touching a trembling or contracting muscle.

For eye twitches, close your eyes for about 15 minutes and relax. You can also apply cotton pads soaked in warm liquid to your eyes. There is also such an exercise: you need to open your eyes wide with force, and then close your eyes sharply for a couple of seconds; this action should be done three times in a row. You can blink quickly with both eyes for a few seconds, and then cover them for two minutes and relax. When twitching any one eye, you can lightly press on the middle of the eyebrow arch above this eye.

As for more serious cases, medicines help to cope with nervous tics. The most commonly used to combat twitching are Haloperidol and Botox. The first refers to antipsychotic drugs, and the second blocks the neuromuscular transmission. Botox is used infrequently - for example, when you need to "mask" a symptom; this substance gives the muscles elasticity, so that twitches become invisible to others.

From herbal remedies, infusions of valerian and motherwort are used.

Of the non-drug methods, behavioral therapy is widely used. Its purpose is to relieve anxiety, develop self-confidence in the patient and, most importantly, to develop the ability to control symptoms.

Of particular difficulty is the treatment of Tourette's syndrome. If it proceeds in a mild form, then all therapy is reduced to the usual elimination of tics, described above. If there are comorbid conditions, then treatment should be directed to them first, as they bring more problems than tics. Of the medications, typical and atypical antipsychotics, antihypertensives, antidepressants, and lithium preparations are indicated. Medicines are prescribed only for severe manifestations of the disease. All of them cause different side effects, so the drugs should be selected by a specialist individually for each patient. There is currently no universal treatment for Tourette's syndrome.

If a child of kindergarten or school age suffers from nervous tics, then parents should warn his classmates, classmates, educators and teachers in advance about the presence of the disease. This is especially true for Tourette's syndrome. Otherwise, the ridicule of others will only worsen the patient's condition, and the tics will become stronger.

The scientific study of nervous tics, including Tourette's syndrome, began only in the 19th century. But they were known even in the Middle Ages. At that time, strange movements, sounds and words were explained by “devil possession”, therefore, as a treatment for patients, an exorcism rite was prescribed, as well as prayers and fasting. Symptoms similar to those of Tourette's syndrome were first described in the famous medieval treatise The Hammer of the Witches, intended for inquisitors. It is clear that the methods proposed there to combat this disease did not work; and often the "possessed" had to be burned at the stake. Now the twenty-first century is in the yard, but even in our time there are poorly educated people who are seized with mystical awe at the sight of pronounced manifestations of nervous tics, and they rush to perform religious rites on the patient, being sure that a demon “sits” in him. Particularly impressive is Tourette's syndrome, which is sometimes referred to as the "anger syndrome": the patient's behavior during seizures resembles outbursts of rage, twitching of the limbs is so strong that he can break the object that he is currently holding in his hands, break or scratch the countertop, inflict himself or others injury. Nervous tics in Tourette's disease from the outside seem to be purposeful manifestations of anger and anger, while patients admit that they cannot control themselves. All this surrounds quite an ordinary nervous disease with a mystical halo and only strengthens the religious beliefs of believers.

In the nineteenth century, scientists finally took up the study of nervous tics and the development of methods for their treatment. And in many respects they were pushed to this by considerations of an ethical and aesthetic nature. Thus, one of the first described patients with symptoms of coprolalia was the Marquise Dampierre, a well-known Parisian aristocrat at that time, famous for her noble manners, high intelligence and noble origin; in sharp contrast to all this was her irresistible craving for obscene curses, which, upon further study, turned out to be a manifestation of a serious illness.

Canadian artist Shane Fistell has been living with Tourette's syndrome for many years. He did not leave his house for years, as the disease prevented normal contact with people. Even when he was first taken to the doctor at the age of seventeen, he could not make a correct diagnosis and tried to expose him, because he thought he was pretending. This was forty years ago, and at that time Tourette's syndrome was still little understood. Today, both doctors and Fistell himself know what his illness really is, but ordinary people are not yet aware. On the streets he is constantly stopped by the police, in the stores he is constantly checked by the guards; they are all sure that this strangely behaving person is prone to committing crimes. One of the passersby doused him with holy water, because he thought that Fistell was possessed by the devil. The artist believes that neither religious rites nor even pills can help him; He sleeps 18 hours a day from prescribed drugs, but the tics do not go away. Fistell even believes that doctors specifically prescribe such drugs to him in order to rid society of him. Despite his illness, in all other respects, Fistell boasts excellent physical health, high intelligence and creative activity.

Prevention of the onset of the disease

As a preventive measure for the appearance of nervous tics, a healthy lifestyle can be recommended. It is also important to properly organize your working time, observe sleep and rest regimes. Nervous tics are unlikely to occur in a person who avoids stressful situations and is able to calmly solve all the problems that arise before him.

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