Causes and risk factors
Several factors can cause the development of facial tics like disorders such as attention deficit hyperactivity disorder [ADHD], obsessive-compulsive disorder [OCD]. Excitement, stress, fatigue, anger, emotional disturbance can also cause facial tics. Types of facial tics are as follows – Transient tic disorder refers to facial tics that last for a short period. It appears nearly every day for more than a month, but less than a year. Chronic tic disorder – Tics are experienced for more than one year with no tic-free periods longer than three months. Tourette’s disorder – it usually begins in childhood with tics in the face, head, and arms and tends to progress in intensity and can affect several body parts. The condition normally declines in adulthood.
Clinical presentation
The tics may be precipitated by severe anger, excitement, anxiety, or emotions. Patient presents with any type of repeated, uncontrolled, spasm-like muscle movements, for example, twitching of mouth, grimacing, blinking of eyes, wrinkling of nose, squinting, repeated clearing of throat, or grunting.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. An EEG may be advised to rule out epilepsy.
Treatment
No treatment is required for most patients. However, if the tics are very severe or persistent, the following can be done – Psychotherapy is required for treating the condition. It involves cognitive behavioral therapy, which teaches anger management techniques and relaxation techniques to combat the problem. Medications like antidepressants, antianxiety drugs, anticonvulsants, and mood stabilizers help in treatment of the disease. Botox [botulinum toxin] injections may be required to temporarily paralyze facial muscles. Treatment of any underlying condition, if present, is given.
Other Modes of treatment
The other modes of treatment can also be effective in treating facial tics. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates is also found to be effective in treating facial tics.
