Provisional Tic Disorder
Tics take the form of abnormal, repetitive, and unintentional movements or vocalizations that do not follow any rhythm or pattern. Provisional tic disorder, previously known as transient tic disorder, is a motor disorder in which the person experiences seemingly involuntary motor and/or verbal tics for under one year. Tics are often described as being preceded by a strong, uncontrollable urge to tic, followed by a release of tension. Some people also report feeling that their tic must be done in a certain way, and they will repeat the tic until it has been done “just right.”
Tic disorders generally surface in childhood, and symptoms usually begin before a child reaches puberty, with an average onset between the ages of 4 and 6. Symptoms tend to be most severe between the ages of 10 and 12 and improve as the child moves into adolescence. Tic disorders are at least twice as common in boys as in girls.
To be diagnosed with provisional tic disorder, a person must have at least one motor or vocal tic that has been present for less than a year. The behavior also must have emerged before age 18 and not be attributable to Tourette's disorder, persistent (chronic) motor or vocal tic disorder, substance use disorder, or another medical condition.
Tics can be either simple or complex. Simple motor tics are quick (milliseconds) and can include:
- Eye blinking
- Facial grimaces
- Shoulder shrugging
- Repetitive touching
- Straightening of the arms or legs
Simple vocal tics include:
- Throat clearing
Complex tics often involve a combination of simple tics, such as simultaneous eye blinking and head turning. They tend to last for a longer period of multiple seconds. Tics can worsen when a person is anxious, excited, or exhausted. Similarly, they may diminish when a person is calm and focused on a particular activity, such as schoolwork.
The specific cause of provisional tic disorder is unknown. It is thought to be influenced by a combination of several factors, including genetic and brain abnormalities and a person’s environment. Tic disorders can run in families and may also be caused or worsened by environmental factors, such older paternal age and maternal smoking during pregnancy. Anxiety, stress, and exhaustion can exacerbate symptoms.
Treatment for a tic disorder is only necessary when the symptoms are severe enough to cause distress in a child or adolescent and interfere with their school functioning or social development. Treatment might include medication or behavioral therapy to reduce the presence and severity of symptoms, as well as improve any distress a person might experience as a result of their tics. Additionally, relaxation techniques can help decrease the frequency of tics.