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As the child ages, these movements typically disappear, although it is possible for one or more to persist into adulthood. If the cause is a physical or mental health threat, then it should be addressed.
Similarly, if the tics are making it difficult for a person to socialize or otherwise live a normal, happy life, it may be necessary to develop a plan to control the problem. Nervous tics that result from neurological problems can sometimes be controlled with muscle relaxants, tranquilizers, or medicines such as clonidine.
Those that are the result of emotional or psychological problems can sometimes be treated through psychotherapy. For those experiencing tics because of Tourettes syndrome, medication can sometimes control the disorder. Disruption of these pathways frequently results in involuntary movements.
Sleep deprivation and other sleep conditions like sleep apnea also may aggravate or trigger symptoms in some people. Reducing or completely eliminating these factors may relieve symptoms. The five basic criteria for clinically diagnosing the disorder are:. Individuals may be asked about frequency, duration, and intensity of symptoms; if movement helps to relieve symptoms; how much time it takes to fall asleep; any pain related to symptoms; and any tendency toward daytime sleep patterns and sleepiness, disturbance of sleep, or daytime function.
Laboratory tests may rule out other conditions such as kidney failure, iron deficiency anemia which is a separate condition related to iron deficiency , or pregnancy that may be causing symptoms of RLS.
Blood tests can identify iron deficiencies as well as other medical disorders associated with RLS. Periodic limb movement of sleep during a sleep study can support the diagnosis of RLS but, again, is not exclusively seen in individuals with RLS.
Diagnosing RLS in children may be especially difficult, since it may be hard for children to describe what they are experiencing, when and how often the symptoms occur, and how long symptoms last. Pediatric RLS can sometimes be misdiagnosed as "growing pains" or attention deficit disorder.
RLS can be treated, with care directed toward relieving symptoms. Moving the affected limb s may provide temporary relief. Sometimes RLS symptoms can be controlled by finding and treating an associated medical condition, such as peripheral neuropathy, diabetes, or iron deficiency anemia.
Iron supplementation or medications are usually helpful but no single medication effectively manages RLS for all individuals. Trials of different drugs may be necessary. In addition, medications taken regularly may lose their effect over time or even make the condition worse, making it necessary to change medications. Lifestyle changes. Certain lifestyle changes and activities may provide some relief in persons with mild to moderate symptoms of RLS.
These steps include avoiding or decreasing the use of alcohol and tobacco, changing or maintaining a regular sleep pattern, a program of moderate exercise, and massaging the legs, taking a warm bath, or using a heating pad or ice pack.
There are new medical devices that have been cleared by the U. Aerobic and leg-stretching exercises of moderate intensity also may provide some relief from mild symptoms. For individuals with low or low-normal blood tests called ferritin and transferrin saturation, a trial of iron supplements is recommended as the first treatment. Iron supplements are available over-the-counter. A common side effect is upset stomach, which may improve with use of a different type of iron supplement.
Because iron is not well-absorbed into the body by the gut, it may cause constipation that can be treated with a stool softeners such as polyethylene glycol. Others may require iron given through an IV line in order to boost the iron levels and relieve symptoms.
Anti-seizure drugs. Anti-seizure drugs are becoming the first-line prescription drugs for those with RLS. The FDA has approved gabapentin enacarbil for the treatment of moderate to severe RLS, This drug appears to be as effective as dopaminergic treatment discussed below and, at least to date, there have been no reports of problems with a progressive worsening of symptoms due to medication called augmentation.
Other anti-seizure drugs such as the standard form of gabapentin and pregabalin can decrease such sensory disturbances as creeping and crawling as well as nerve pain.
Dizziness, fatigue, and sleepiness are among the possible side effects. Recent studies have shown that pregabalin is as effective for RLS treatment as the dopaminergic drug pramipexole, suggesting this class of drug offers equivalent benefits. Dopaminergic agents. These drugs, which increase dopamine effect, are largely used to treat Parkinson's disease.
They have been shown to reduce symptoms of RLS when they are taken at nighttime. These drugs are generally well tolerated but can cause nausea, dizziness, or other short-term side effects. Levodopa plus carbidopa may be effective when used intermittently, but not daily. Some complex motor tics include gestures like jumping, squatting, hand motions , and touching or smelling an object repeatedly, among other things. Additionally, complex vocal tics include palilalia repeating one's own speech ; coprolalia the utterance of obscene words ; and echolalia repeating someone else's speech.
There are different types of conditions related to nervous tics, and these are the three criteria that you can use to differentiate between them:. Below, we specify the 3 most common disorders involving nervous tics: transient tic disorder, chronic motor or vocal tic disorder, and Tourette's syndrome.
The defining characteristic of transient tic disorder is that it most often appears before the individual's 18th birthday. These nervous tics usually happen every day for at least 4 weeks, but only for a period of 1 year or less. In addition to this, a child or adolescent diagnosed with this disorder can't meet the criteria for Tourette's syndrome or chronic motor tic disorder.
The tics seen in this disorder can either be motor or vocal, but not both. In this case, to be diagnosed with this syndrome, the individual has to be under 18 years of age. In this case, these tics need to occur several times a day, almost every day or intermittently for a period of more than 1 year. Finally, for diagnosis, the child cannot present symptoms of Tourette's syndrome. Tourette's syndrome is the most serious of the 3 tic disorders that we've mentioned. As with the prior, the individual needs to be under 18 for diagnosis.
In this case, multiple vocal and motor tics need to be present, although not necessarily simultaneously. Plus, these symptoms must appear several times throughout the course of the day, almost every day or off and on, for a period of more than a year.
In diagnosing Tourette's syndrome, there are also variations regarding the location, severity, complexity, frequency, and number of tics present over a period of time; and finally, these nervous tics can't be the result of any substance like stimulants or a central nervous system disease. As we said, nervous tics happen for many different reasons. Therefore, there are various options to stop them if this is possible depending on whether the movements are sporadic, or if they are the consequence of any of the disorders that we mentioned previously.
In the first case, this is probably an involuntary reflex that happens when the individual is experiencing stress. So, the best way to get rid of tics, in this case, is through relaxation and coming up with better stress management strategies. If the tic continues, after trying these methods it might be time to reevaluate the situation since this means that there could be another underlying cause.
On the other hand, for those with any of the three tic disorders we mentioned before, applying a holistic, multidisciplinary approach that allows for a comprehensive treatment plan is one of the best options. This means that the treatment plan should include everything from psychoeducation and appropriate evaluation to psychotherapy, and possibly pharmacological intervention if necessary. In this case, the patient and his or her family should receive psychoeducation.
This consists of providing accurate information regarding the course and progression of the affected person's condition. Naturally, for this to happen, previous diagnostic testing and appropriate evaluation are necessary.
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