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Life's A Twitch! Celebrating 15 years.
1998 - 2018
Life's A Twitch! Celebrating 15 years.

 

Question 81: My 9 year old has just been diagnosed with TS that seemed to have come on immediately, within a month or two, after taking Concerta for his ADHD (which he has always had). He has severe motor tics, some vocal and severe OCD now. My question to you after reading your response to question 7 where you say “an area of the brain that is involved in inhibiting "incidental associations" made between different motor movements (like, say, walking through a doorway and blinking simultaneously) is not functioning properly in individuals predisposed to TS. Therefore common actions (such as eye-blinking) become "connected" to a great number of regular activities, resulting in what we call tics (in this case, an eye-blinking tic).” Doesn’t seem to make sense in my son’s case in which he has complex motor tics such as he raises his arms up to the height of his ears, closes his eyes, smiles and shakes his head violently. This seems to have nothing to do with “regular activities” of any kind. Please help me to understand this very unfortunate thing that has happened to my child. Thank you. R., CO, USA.


Good morning R.:

I would suggest reading my doctorate in it's entirety rather than just response 7's marginal description of it, or at least the introduction and discussion sections of the thesis. It can be found at www.lifesatwitch.com/phd.html. It is a somewhat involved theory that is difficult to condense into a short answer (which is why I only gave a brief example of how a simple tic is formed in the response you refer to). More complex tics such as the ones you describe can certainly be accounted for by the Incidental Associations theory as well, but given the single example you've read thus far I can understand your initial confusion -- I have many pronounced tics that on the surface couldn't have been formed as simplistically as in that example either.

When reading the theory in full, one of the things to bear in mind is that each of the movements you describe in your son in and of themselves are not bizarre: each in isolation could and often do have appropriate contexts where they would not look unusual at all. It is the firing of those movements WITHOUT such a context, and the association of them all together, which makes them appear strange. That's one of the keys to understanding the neurology of TS and the development of tics -- simple tics, once formed, can then be incidentally associated with other simple tics and those can associate with still others in an increasingly intricate web of connections.

Happy reading! I hope this helps,
Dr. Dunc.

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Last updated on March 25, 2022

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