The Increasing Prevalence of Tic Disorders in Children: Causes, Diagnosis, and Treatment Options

Increase in Hospital Treatment for Tic Disorders Indicates a Growing Concern

In recent years, there has been a significant rise in the number of patients seeking hospital treatment for tic disorders, according to data from the National Health Insurance Corporation. From approximately 79,000 cases in 2017, the number has surged to around 94,000 in 2021. Tic disorders, characterized by sudden, rapid, and repetitive movements, occur involuntarily and are often a manifestation of an underlying condition. In some cases, deliberate movements aimed at alleviating discomfort are also classified as tic disorders.

While the causes of tic disorders, attention-deficit/hyperactivity disorder (ADHD), and obsessive-compulsive disorder (OCD) can be approached from different angles, many experts attribute them primarily to the influence of dopamine, a neurotransmitter. The excessive secretion of dopamine in specific areas of the brain, caused by heightened tension and excitement, is considered the primary driver of tic disorder symptoms. Notably, the excessive use of smartphones, which stimulates the brain, has been identified as one of the contributing factors behind the recent surge in tic disorders.

When tic disorders or ADHD are suspected, it is crucial to accurately diagnose the condition through objective and scientific tests that evaluate brain function. Quantifiable electroencephalography (QEEG), autonomic nervous system tests, comprehensive attention tests, and balance tests can aid in identifying the current condition. Based on the diagnosis, medicinal treatments may be recommended in order to establish an appropriate treatment plan.

Differentiating Motor Tics and Vocal Tics

Tic disorders are predominantly categorized into motor tics, involving muscular movements, and vocal tics, characterized by repetitive sounds. Motor tics manifest as uncontrollable twitches in specific body parts. Common symptoms include eye blinking, nose twitching, and facial grimacing. In severe cases, individuals may experience excessive movement of the neck or mouth, shaking of the shoulders, or even full-body strain. On the other hand, vocal tics involve the repetitive production of sounds irrespective of the person’s will. This can include coughing noises from the nose or throat, meaningless vocalizations such as “ah” or “hmm,” and inexplicable animal noises.

It is important to note that a diagnosis of Tourette syndrome is made when both motor and vocal tics persist continuously for more than six months. Unfortunately, many cases go untreated, with individuals assuming the condition will improve on its own over time. However, it is crucial to initiate treatment as early as possible to prevent the disorder from progressing into chronic tic disorder or adult tic disorder.

The Impact of Pediatric ADHD and the Importance of Early Intervention

In the case of pediatric Attention Deficit Hyperactivity Disorder (ADHD), symptoms are characterized by a lack of attention, poor concentration, and impulsive and excessive behavior. If left unaddressed, pediatric ADHD can lead to learning disabilities, behavioral disorders, and other issues that hinder normal socialization processes. In fact, if not effectively managed, pediatric ADHD can persist into adulthood. Moreover, due to the criticism often faced by children with ADHD for their problematic behavior, they may develop low self-esteem, heightened anxiety, and tension. Consequently, this can increase the risk of developing anxiety disorders or obsessive-compulsive disorder.

Unfortunately, guardians dealing with tic disorder and ADHD symptoms sometimes mistakenly perceive their child’s behavior as deliberate and resort to harsh reprimands or excessive discipline. Such responses can have a detrimental impact on the child’s tic and ADHD symptoms. It is crucial to avoid negative expressions, pitying attitudes, or sighs, even if attention is not drawn verbally to the child’s symptoms.

A Comprehensive Approach to Treatment and Care

Addressing these conditions requires time and consistent treatment. When the brain stabilizes through ongoing therapy, symptoms are more likely to stabilize as well. Therefore, it is important to be patient and accept treatment comfortably.

Children with tic disorders often expend significant energy trying to control their tics, which leaves them constantly fatigued and stressed. Engaging in exercise can significantly reduce stress levels and enhance overall brain function, including the basal ganglia. However, it is recommended that exercise does not involve any competitive elements. Moreover, it is counterproductive to continuously monitor and scrutinize the child’s symptoms. Instead, allowing them the space to vent their tics and emotions in a supportive environment is beneficial. Additionally, the entire family should collectively strive to minimize time spent on smartphones, games, and other similar activities.

It is essential to understand that having tic disorders or ADHD does not prevent individuals from leading normal lives. With long-term management and a positive, relaxed mindset, these conditions can be effectively managed, regardless of whether symptoms improve or worsen.

Written by Seok Seon-hee, Director of Haearim Oriental Medicine Clinic, Jamsil Songpa Branch.

According to the National Health Insurance Corporation, the number of patients receiving hospital treatment for tic disorders increased from approximately 79,000 in 2017 to approximately 94,000 in 2021. Tic disorder in children refers to sudden, rapid, repetitive and incoherent. Usually, it appears regardless of the person’s will, but deliberate movements made to relieve an unpleasant or uncomfortable sensation (aura sensory stimuli) are also included as tic disorders.

The causes of tic disorders, ADHD, and obsessive-compulsive disorder can be looked at from different perspectives, but many consider them primarily due to the influence of dopamine, a neurotransmitter. The main cause of the symptoms of a tic disorder is increased dopamine secretion due to excessive tension and excitement in certain parts of the brain Excessive use of smartphones excites the brain, which is one of the causes of the recent surge.

Therefore, if a tic disorder or ADHD is suspected, the current condition can be accurately identified through objective and scientific tests related to brain function such as quantifiable electroencephalography (QEEG), autonomic nervous system test, comprehensive attention test, and balance test of the cerebral, and oriental. medicinal treatment may be recommended It is important to set a direction.

Tic disorders are mainly divided into motor tics (muscular tics) and vocal tics. Motor tics are repetitive uncontrollable twitching of a specific part of the body.

The symptoms are mainly blinking of the eyes, twitching of the nose, and grimacing of the face, and in more severe cases, the symptoms include excessive movement of the neck or mouth, shaking of the shoulders, and straining the whole body. Vocal tics are when a person makes sounds repeatedly regardless of their will. This includes making coughing noises from the nose or throat, repeatedly making meaningless noises such as ah, hmm, or making inexplicable animal noises.

In addition, when the combination of muscular and vocal tics continues for more than 6 months, it is diagnosed as ‘Tourette syndrome’. There are many cases where treatment is missed, thinking that it will get better on its own if left alone, but treatment must be started as soon as possible to prevent it from progressing Tourette’s disorder, chronic tic disorder, or adult tic disorder.

Pediatric ADHD can be expressed as ‘Attention Deficit Hyperactivity Disorder’ in Korean. It is characterized by a lack of attention, poor concentration, and impulsive and excessive behaviour. It can develop into learning disabilities, behavioral disorders, etc., which can cause many problems in the normal socialization process and lead to adult ADHD, so coping active is necessary. Because children with ADHD receive a lot of criticism for their problematic behaviour, they are likely to perceive themselves as bad children and have low self-esteem or high levels of anxiety and tension. Because of this, it can easily lead to an anxiety disorder or obsessive-compulsive disorder.

Sometimes guardians dealing with symptoms of tic disorder and ADHD think their child is doing it on purpose when they see the child’s symptoms and reprimand or discipline them harshly. This can have negative impact on the child’s tics and ADHD symptoms. Even if you don’t draw attention to your child’s symptoms verbally, you must be careful about angry expressions, pitiful attitudes, sighing, etc., as they can have a more negative effect.

These diseases do not heal quickly all at once. If the brain becomes stable through consistent treatment, the symptoms may also stabilize, so you should take your time and be able to accept treatment comfortably.

Children with tics spend a lot of energy trying to control their tics, so they are always tired and stressed. Exercise is useful for reducing stress and strengthening overall brain function, including the basal ganglia, but exercise is best without competitive elements. It is very bad to observe and monitor your child’s symptoms 24 hours a day, and it is good to allow them to vent their tics or emotions in their own space. In addition, the whole family should work together to reduce the amount of time spent using smartphones, games, etc.

Just because you have tics doesn’t mean you can’t live a normal life. Tic and ADHD disorders can be easily overcome if you manage them over a long period of time with a positive and relaxed mind without worrying too much about improving or worsening the symptoms.

write. Seok Seon-hee, director of Haearim Oriental Medicine Clinic, Jamsil Songpa Branch

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