Childhood Tics: Why They Happen and When to See a Family Physician

Irina Pronkinova — GP, pediatrician, neurologist

Tics affect up to 20% of school-age children. In most cases, they are temporary (transient) and resolve on their own without medication.

For many expat families in the UAE, noticing sudden blinking, throat-clearing, or facial twitches can trigger significant worry, often leading to immediate requests for brain imaging or extensive specialist referrals.

Here is what parents need to know based on evidence-based guidelines from the American Academy of Neurology (AAN) and the American Academy of Pediatrics (AAP).

What Is a Tic?

A tic is a sudden, rapid, repetitive movement (motor tic) or sound (vocal tic) that occurs in response to an internal urge.

• Motor tics: frequent eye blinking, nose scrunching, head turning, shoulder shrugging.
• Vocal tics: throat-clearing, sniffing, grunting, squeaking.

Tics are semi-voluntary. Children often describe a physical tension or discomfort right before the movement, similar to the urge to sneeze or scratch an itch. A child can hold back a tic for a short time through sheer effort, during class or an assembly. However, that internal tension builds up until the tic has to release, often appearing more frequently once the child is relaxed at home.

Why Telling Them to Stop Makes It Worse

Asking a child to “stop blinking” or “sit still” is counterproductive. Suppressing a tic requires active effort, causes fatigue, and elevates anxiety.

Drawing attention to tics often intensifies them. It can also create secondary issues: self-consciousness, shame, and withdrawal from peers.

The most effective approach for parents, teachers, and nannies is to ignore the tics completely and avoid discussing them in front of the child.

What Triggers Tics?

Tics naturally wax and wane. They are not intentional, nor are they a sign of poor discipline. Common triggers include:

• Fatigue and shifting sleep schedules.
• Prolonged screen time, especially before bedtime.
• Strong emotions, both stress and joyful excitement.
• Life changes: the start of the school year, exams, moving house, or changing schools.

When to Seek Medical Evaluation

Families often wait for severe signs or visit emergency rooms unnecessarily. A structured outpatient consultation with a General Practitioner helps early on:

• Differential diagnosis: Other conditions are sometimes mistaken for tics: allergies (constant sniffing, or dry eyes from air conditioning), seizures, or compulsive habits. A direct examination tells them apart.
• Identifying co-occurring conditions: Tics often come with attention deficit, heightened anxiety, fears, or impulsivity. Often these difficulties bother the child more than the movements themselves.
• Assessing impact on daily life: A visit is warranted if tics cause physical soreness, interfere with handwriting, reading, or sleep, or make the child self-conscious in front of peers.
• Monitoring duration: When both motor and vocal tics persist together for more than 12 months, evaluation for Tourette syndrome is appropriate.
• Red flags that require prompt attention: movements affecting only one side of the body, weakness in an arm or leg, sudden freezing episodes, loss of consciousness, or loss of previously acquired skills.

Evidence-Based Management

• Psychoeducation and watchful waiting: For most children, reassurance and understanding that the condition is benign relieve parental anxiety, which directly helps reduce the frequency of tics.
• Behavioral support (CBIT): Comprehensive Behavioral Intervention for Tics teaches children to recognize the premonitory urge and deploy a competing, neutral movement.
• Medication is reserved for severe impairment: Prescription drugs are considered only when tics cause significant physical discomfort or disrupt learning and social integration. Nootropics, supplements, vascular IV drips, and herbal sedatives have no proven effect and are not used in international practice.

Consultations at GMS

Consultations at GMS are led by a General Practitioner (GP) with clinical training in pediatrics and neurology.

This background allows us to evaluate both general health and neurodevelopmental concerns in a single appointment:

• Accurately differentiate tics from allergies, habits, or other movement patterns.
• Assess motor and speech development and the quality of the child’s sleep.
• Adjust the daily routine, workload, and rest to life in Dubai.
• Protect families from unnecessary investigations, polypharmacy, and unproven treatments.

Neurologist consultation — AED 750; combined pediatrician and neurologist consultation — AED 900. Consultations in English and Russian.

Sources

• American Academy of Neurology. Treatment of Tics in People with Tourette Syndrome
• American Academy of Pediatrics. Tics and Tourette Syndrome

FAQ

Why see a doctor if tics often go away on their own?

The doctor checks that it really is a tic and not an allergy, seizures or a compulsive habit. They also look at co-occurring difficulties such as attention deficit, anxiety, fears or impulsivity, which often bother the child more than the movements themselves.

What triggers tics?

Lack of sleep and physical overtiredness, long phone or tablet use before bed, strong emotions (both stress and joyful excitement), and life changes such as the start of the school year, exams, moving house or changing schools.

Which signs need prompt attention?

Movements on only one side of the body, weakness in an arm or leg, sudden freezing episodes, loss of consciousness or loss of previously acquired skills. When motor and vocal tics persist together for more than 12 months, evaluation for Tourette syndrome is appropriate.

This article is for information only and does not replace a consultation. If you have symptoms, see a doctor.

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