Monday, June 27, 2011

Tic, Tac Twitch



Tics and twitches (medically called dystonia) are involuntary muscle contractions that result in a twisting or repetitive movement or abnormal postures. Examples would be a twisting of the neck or writer’s cramp or repetitive blinking of the eyes. The first time may have been triggered by an activity or event but over time the twitch becomes susceptible to less and less stimuli, even at rest. 

Most tics/twitches occur early in age but some may present older (more than 26 years of age). The abnormal movement can involve a body part such as a finger, or a leg or the trunk or even one side of the body. Some are inherited, some occur at birth (such as from brain injury), and others are acquired later on due to unknown reasons. It is interesting that the earlier the onset, the more likely it will present in the limbs (arms, legs) whereas older presentations occur in the neck, arm or face. 

Examples:

  • Common types include: neck—spasms of neck and shoulders
  • Blepharospasm—spasms of muscles around the eyes leading to involuntary eye closure and incessant blinking.
  • Facial—jaw, tongue, or facial muscles spasm out
  • Limbs—movements of the arm or leg
  • Voice—a high pitch tremor nasally sound
  • Occupational—writer’s cramp; typists; golfers spasm( the yips); and musicians mouth that twists including the jaw or tongue. Usually, when the activity is over so it the twitch. 
      Late onset twitch starts usually in the face, arm, neck. It rarely goes generalized. If so, further workup is definitely suggested.

There is good genetic linkage for early onset twitches and possibly with late onset.  If interested, ask for the DYT1 gene testing. Always have a doctor evaluate the twitch as it may be unusual and need further workup.
The main idea here is that a tic, a twitch or a dystonia is common and does not necessarily mean a seizure disorder. Tics in particular are usually accompanied by a sense of having to perform the tic and are relieved by doing it. A tic as well may be temporarily suppressed. The movements of these are also quite variable in comparison to a seizure. Also, there is a degree of suppression that can be achieved as opposed to a seizure.


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Dr. Frank Marinkovich owns and operates Eastside Family Health Center in Kirkland, WA. Serving Kirkland and the Eastside, Seattle, Bellevue, Renton and the surrounding local communities. Specializing in Primary Care, Automobile Accidents and FAA physicals. Visit them online at Eastside Family Health Center or call them at (425) 899-2525.
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