What is Facial Tic Disorder?
A facial tic disorder is an uncontrollable, involuntary muscle spasm in the face such as rapid eye blinking and nose scrunching. Facial tic disorder often becomes a nuisance to the person who experiences it.
As these are involuntary that can be suppressed temporarily.
Facial tic disorder most commonly affects children but can occur in adults as well. Also, tics are more common in boys than girls.(1)
Facial tic disorder is not a serious medical condition and the children outgrow it within a few months.
What Are Facial Tics?
Facial tics are the involuntary muscle movements that can occur anywhere on the face. Most of the time they are seen occurring in the same places, frequently, bothering the person. This affects the quality of life of a person.
The most common facial tics are:
- Flaring of the nostrils
- Squinting
- Rapid eye blinking
- Sucking the teeth
- Raising of eyebrows
- Clicking the tongue
- Mouth twitching
- Scrunching the nose
- Opening and closing the mouth
Sometimes along with muscular twitching, some people may also experience vocal tics that would involve clearing the throat and grunting.
Causes of Facial Tic Disorder
There are several disorders that can cause facial tics. The severity and frequency of the tics depend on the disorder causing them.
Transient Tic Disorder
Facial tics lasting for a short period of time can be diagnosed as transient tic disorder. Tics due to this disorder may occur every day for more than a month and would resolve without any treatment.
This is a common condition in children and is a form of Tourette’s syndrome.
Tics form transient tic disorder may include:
- Blinking eyes
- Flaring nostrils
- Opening the mouth
- Grunting
- Clicking the tongue
- Raising eyebrows
Chronic Motor Tic Disorder
A chronic motor tic disorder is less common occurring than transient tic disorder. A person who experiences tics for more than a year is diagnosed with a chronic motor tic disorder.
The tics in this disorder include:
- Excessive blinking
- Grimacing
- Twitching
Tics in this disorder may occur during sleep as well.
Most of the time children aged 6-8 years, if diagnosed with chronic motor tic disorder would not require any treatment. The symptoms would subside on their own.
If diagnosed later in life, it may need treatment, depending on the severity of the tics.
Tourette’s Syndrome
Tourette’s syndrome is a chronic condition that can lead to one or more motor or vocal tics.
It appears at the age of 7 and the child may experience spasms on the face, head, and arms.
As the tics intensify they can spread to other parts of the body. The severity of the tics lessens in adulthood.
The associated tics are:
- Sticking out of the tongue
- Flapping arms
- Shrugging of shoulders
- Obscene gestures
- Inappropriate touching
- Vocalizing of curse words
The vocal tic would include excessive hiccupping, throat clearing, and yelling.
This disorder can be managed with behavior treatment, and a few would require medications.
There are certain factors that can lead to facial tic disorders, which include:
- Stress
- Fatigue
- Excitement
- Stimulant medications
- Heat
- Attention deficit hyperactivity disorder
- Obsessive-compulsive disorder
Diagnosis of Facial Tic Disorder
Facial tic disorder can be diagnosed by giving the symptoms experienced to the medical health professional.
Electroencephalogram (EEG) is advised to measure the electrical activity of the brain. It can diagnose any seizure disorder responsible for causing symptoms.
Electromyography (EMG) can be performed to evaluate muscle or nerve problems.
Treatment of Facial Tic Disorder
Most of the facial tic disorder would not require any treatment.
Treatment would be required if the tics affect social interactions, job, schoolwork or performance. The treatment options include:
- Psychotherapy
- Behavior therapy
- Stress reduction programs
- Anticonvulsant topiramate
- Antipsychotic medications
- Medications to treat ADHD and OCD
- Botulinum toxin
Studies show that Tourette’s syndrome can be treated with deep brain stimulation, which is a surgical procedure through which electrical impulses are sent to the brain to restore brain circuitry to more normal patterns.(2)
Cannabis-based medication can also be helpful in reducing tics. These medications cannot be given to children, adolescents, pregnant females and nursing women.
Facial tic disorder is not a serious condition and would not require any treatment, unless it interferes with everyday life. Speak with your healthcare professional, if any such symptom is bothering you.
