Twitches & tics worry parents

Posted by Barbara F. Meltz  June 5, 2012 06:00 AM

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My 3 yr old daughter has started twitching just 2 weeks ago. She touches/rubs her nose,ears,eyes and takes her hand over her head at least 6-7 times in a day. She does so more in public,with other children and when she is tired/sleepy. She is our only child and we are not sure why she is doing it. She goes to a playschool but I did notice that no other child in her class does it. Need Your help...what should we do?---ignore it, take her to pediatrician...? Please help.

From: AC, Alpahretta, GA

Hi AC,

So first, let's get the lingo down. Twitching is an involuntary motion of a muscle, a spasm or trembling. What you're describing sounds more like a tic, which is also involuntary but is a movement of the muscle that happens abruptly and repeatedly.

Tics -- a jerk of the head, a swipe of the nose, shrugging or blinking -- are not unusual in childhood and most kids don't realize they are doing it. You can certainly guide her hand away from her face if you see the motion coming, but otherwise, with a child this young, trying to stop or correct it may be not only hard but unpleasant. As hard as it might be to observe this, the toughest part about it may be learning to tolerate it because the more attention you bring to it, the more likely it is that you will inadvertently reinforce the motions. I assume, by the way, that you mention she has no siblings as your way of saying you have no basis for comparison. But I bet if you ask other parents, you'll discover that this is not so uncommon. Let me also say, as the parent of an only myself, that when there is only one child, we tend to hyper-identify and over-analyze everything. As understandable as that is, it's in everyone's interest to ratchet that down.

Tics can be caused by medication (is she on any?), recreational drugs (I assume we can rule that out!) and stress, both positive and negative, and also -- as you've indicated -- by a need for sleep. In other words, benign. Given your description, I'd guess that your daughter might fall into the last two categories; for instance, being excited about playschool, about her playmates and activities, would be an example of positive stress. )Some kids jump up and down when they are excited and don't even realize it, and it's such a signal of happiness that we don't register it negatively.) Negative stress could be as simple as change of any kind: Has there been a new teacher? A change in routine?

I wouldn't go jumping to conclusions here (are you worrying about the onset of Tourette's or a conduct disorder?) but because tics and twitches can be symptomatic of a number of disorders, I suggest making your pediatrician aware of your concern. My guess is he/she will advise you to keep an eye on it. It may well diminish on its own, waxing and waning over time.

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6 comments so far...
  1. Hi,
    My son exhibited very similar tics, except his started at the age of two. He would also exhibit his much more frequently when he was tired or stressed. We talked to his pediatrician and she said to monitor it, but then he started doing a lot more so we ended up seeing a pediatric neurologist so that we could rule out seizure disorders or other types of disorders. His tics wax and wane and range from motor tics to vocal tics to exhibiting both at the same time. None of his friends or classmates notice or comment. His neurologist classified it as complex motor tics. I had all sorts of concerns as well, but his pediatrician and neurologist were big helps at alleviating any anxiety that I had. I wouldnt jump to conclusions, but I would speak to the pediatrician about it just to be on the safe side. I felt better getting answers from the doctor, rather than taking a wait and see attitude. Good Luck!

    Posted by Heather June 5, 12 04:20 PM
  1. This doesnt soudn like anything to worry about but I would suggest simply being aware of PANDAs. Tics can be triggered by a strep infection even if your child isnt' presenting with a sore throat. It wouldnt hurt to do a strep test to play it 100% safe.

    Posted by Anonymous June 6, 12 10:58 PM
  1. If you feel this..than see a pediatric developmental specialist. It can't hurt. My son has tics at 5 years old. Some kids have sensory issues going on which are completely normal and others could be a sensory "disorder" so to speak. Barbara is right that you should not jump to conclusions that it could be Tourettes or something else. Tourettes typically isn't diagnosed in children until they reach 5 or 6 years old. I remember a Pediatrics developmental tellimg me that when I had my son evaluated. I definitely would't worry though. But see someone if you have concerns.

    Posted by jd June 7, 12 11:53 AM
  1. I have noticed for several months that my grandson has different type tics. It started out with eye blinking which went away. He was fine during Christmas but this weekend his body twitches at times which I have seen before.I know he cannot help it, he is 7 years old. He is not on any medication at this time. Would you suggest he see a pediatrician?

    Posted by Kathy Rowe January 13, 13 07:17 PM
  1. My 9 yr old has had tics for 1 1/2 yrs now.... They were coming and going.... With shoulder shrugs, blinking, face grimacing, etc... In the past 3 months her tics have been consistent, without any breaks at all. They r mostly in her eyes, eyebrows, and neck. They r now giving her headaches and bothering her eyes. She is having trouble focusing when she speaks because her tics r so distractable to her. She didn't use to notice she was doing them, now they bother her. She saw a neurologist and another physician.... And after testing for seizers, they both told me that this was common in kids and they would disappear .... Now they r worse and I don't know where to turn. I need info on a good hospital or specialist to take her to, but don't know where to go. I'd b willing to travel out of state without question.... Can u help?

    Posted by Kelli Watson March 16, 13 11:31 PM
  1. Hi Kelli,
    My son has Tourette's(he is 7) and sees a doctor in the Pediatric Neurology dept at Boston Medical center. Her name is Rinat Jonas and she is awesome. She really knows what she is talking about and is very thorough in her exams. She talks with the parents but also talks with the child and does all sorts of "tests" that the child doesnt even realize they are doing. I like her because she didnt immediately try to push medication. You should call BMC and see if you can get your daughter in there. Good Luck!

    Posted by Heather March 30, 13 11:13 PM
 
6 comments so far...
  1. Hi,
    My son exhibited very similar tics, except his started at the age of two. He would also exhibit his much more frequently when he was tired or stressed. We talked to his pediatrician and she said to monitor it, but then he started doing a lot more so we ended up seeing a pediatric neurologist so that we could rule out seizure disorders or other types of disorders. His tics wax and wane and range from motor tics to vocal tics to exhibiting both at the same time. None of his friends or classmates notice or comment. His neurologist classified it as complex motor tics. I had all sorts of concerns as well, but his pediatrician and neurologist were big helps at alleviating any anxiety that I had. I wouldnt jump to conclusions, but I would speak to the pediatrician about it just to be on the safe side. I felt better getting answers from the doctor, rather than taking a wait and see attitude. Good Luck!

    Posted by Heather June 5, 12 04:20 PM
  1. This doesnt soudn like anything to worry about but I would suggest simply being aware of PANDAs. Tics can be triggered by a strep infection even if your child isnt' presenting with a sore throat. It wouldnt hurt to do a strep test to play it 100% safe.

    Posted by Anonymous June 6, 12 10:58 PM
  1. If you feel this..than see a pediatric developmental specialist. It can't hurt. My son has tics at 5 years old. Some kids have sensory issues going on which are completely normal and others could be a sensory "disorder" so to speak. Barbara is right that you should not jump to conclusions that it could be Tourettes or something else. Tourettes typically isn't diagnosed in children until they reach 5 or 6 years old. I remember a Pediatrics developmental tellimg me that when I had my son evaluated. I definitely would't worry though. But see someone if you have concerns.

    Posted by jd June 7, 12 11:53 AM
  1. I have noticed for several months that my grandson has different type tics. It started out with eye blinking which went away. He was fine during Christmas but this weekend his body twitches at times which I have seen before.I know he cannot help it, he is 7 years old. He is not on any medication at this time. Would you suggest he see a pediatrician?

    Posted by Kathy Rowe January 13, 13 07:17 PM
  1. My 9 yr old has had tics for 1 1/2 yrs now.... They were coming and going.... With shoulder shrugs, blinking, face grimacing, etc... In the past 3 months her tics have been consistent, without any breaks at all. They r mostly in her eyes, eyebrows, and neck. They r now giving her headaches and bothering her eyes. She is having trouble focusing when she speaks because her tics r so distractable to her. She didn't use to notice she was doing them, now they bother her. She saw a neurologist and another physician.... And after testing for seizers, they both told me that this was common in kids and they would disappear .... Now they r worse and I don't know where to turn. I need info on a good hospital or specialist to take her to, but don't know where to go. I'd b willing to travel out of state without question.... Can u help?

    Posted by Kelli Watson March 16, 13 11:31 PM
  1. Hi Kelli,
    My son has Tourette's(he is 7) and sees a doctor in the Pediatric Neurology dept at Boston Medical center. Her name is Rinat Jonas and she is awesome. She really knows what she is talking about and is very thorough in her exams. She talks with the parents but also talks with the child and does all sorts of "tests" that the child doesnt even realize they are doing. I like her because she didnt immediately try to push medication. You should call BMC and see if you can get your daughter in there. Good Luck!

    Posted by Heather March 30, 13 11:13 PM
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Barbara F. Meltz is a freelance writer, parenting consultant, and author of "Put Yourself in Their Shoes: Understanding How Your Children See the World." She won several awards for her weekly "Child Caring" column in the Globe, including the 2008 American Psychological Association Print Excellence award. Barbara is available as a speaker for parent groups.

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