Which can cause twitching in your forehead

Tics: uncontrolled twitching and throat clearing


Up to 20% of children in elementary school have transient tics. But in only a small proportion of them, tics are expressed as shouting obscene words. Most tic disorders start in childhood. Temporary tics last a maximum of a year. When tics first appear, they often affect the face - blinking, grimacing, or clearing throat can be symptoms. Children and adolescents whose tis last longer are chronically ill. Then the tics usually migrate to the limbs over time and become more complex ...

Constant clearing of the throat, frowning, irregular blinking or uncontrolled screaming: Almost everyone has experienced a person with such a tic. Mostly these are temporary disorders, but sometimes they become chronic and require treatment. Medication can alleviate symptoms, and behavior therapy helps people cope better with the disease. But it cannot be cured - only controlled.

"Tics are short muscle twitches that repeat themselves irregularly," explains Prof. Veit Rößner from the Dresden University Hospital. Tic disorders are expressed by movements or sounds that occur absolutely unplanned. The disease is divided into motor and vocal tics. But there are also those affected who suffer from combined tic disorders, the so-called Tourette's syndrome. The association of Tourette's syndrome with shouting obscene words "only applies to a very small proportion of those affected".

Most of the patients are children and adolescents. "Up to 20% of children in elementary school have temporary tics," says Rößner, who heads child and adolescent psychiatry at the university clinic. Temporary tics last a maximum of one year. When tics first appear, they often affect the face - blinking, grimacing, or clearing throat can be symptoms.
After primary school, the number of children and adolescents affected drops to around 3 to 4%. Patients who have had their tics for more than a year are considered chronically ill. With them it is often the case that the tics then also migrate to the limbs and become more complex. The twitches often slow down, but usually affect multiple muscles.

Those affected often suspect when a tic becomes noticeable "Stress can exacerbate the tics," adds Jürgen Wild from the Professional Association of German Psychologists in Berlin. But otherwise there would be no researched cause for tic disorders. "In some families a genetic predisposition is obvious," says Carmen Grieger from the Tic and Tourette Syndrome Association in Bremen. In general: Anyone can get tic disorders, but it is much less likely in adulthood than in children. They can disappear just as spontaneously as they occur.

Some patients develop a premonition and feel when the tic comes. "It's a feeling similar to before you sneeze," says Rößner. Especially adults affected notice a kind of inner tension, inner restlessness or a tingling sensation. This can be used for perception training: those affected learn to recognize the impending tic and willingly suppress it.

Sick people often suffer from teasing People who are affected often have to live with teasing at school or laughing and shaking their heads on the street. These reactions increase their level of suffering and trigger fear of certain situations. For example, a child can be very embarrassed if they make unintentional loud noises in a quiet classroom or if they involuntarily twitch. “Tics can also be provoked by being aped by others,” explains Grieger.

Such situations can have a negative impact on self-esteem. In behavior therapy, strategies are therefore developed in order to behave confidently in such situations. The ideal attitude of an affected person is: "I have a tic, so what?" Knows Wild. The movements and sounds cannot be controlled, so the patients should expect this sight from their environment. Parents could save their child from inconvenience by informing their teacher as soon as possible. Then the child's behavior will not be interpreted as wrongdoing.

Prohibiting puts additional pressure on the child Teachers and parents should not try to ban a child from the tic. This can lead to additional stress. And praise for “tic-free times” can provoke tics just as much as the ban. Normal behavior is ideal, as if the tics were nothing special - those affected want acceptance and tolerance. If someone cannot help but laugh, the psychologist Jürgen Wild advises addressing them directly. An apology like "I'm sorry, I had to laugh because you looked so strange" is appropriate.