Tics (tic) and involuntary movements in children - NICE guidance - suspected neurological conditions - recognition and referral

Tics and involuntary movements in children

Summary points from NICE relating to tics and involuntary movements in children are:

Sudden-onset involuntary movements

• refer immediately children who have sudden-onset chorea, ataxia or dystonia for neurological assessment

Tics

• do not routinely refer children with simple motor tics that are not troublesome to the child
  
  
• advise parents or carers of children with a tic disorder to discuss the disorder with the child's school, emphasising that the tic is an involuntary movement and the child should not be reprimanded for it
  
  
• do not offer medicine for motor tics in children without specialist referral and advice
  
  
• be aware that tics and stereotypies (repetitive or ritualistic movements such as body rocking) are more common in children with autism or a learning (intellectual) disability
  
  
• for children with a tic disorder that has a significant impact on their quality of life, consider referring according to local pathways, as follows:
  • referral to mental health services if the tic disorder is associated with symptoms of anxiety or obsessive compulsive behaviour
  • referral to the neurodevelopmental team if the tic disorder is associated with symptoms suggestive of autism or attention deficit hyperactivity disorder
  • referral for neurological assessment if the tic disorder is severe

Reference:

• NICE (May 2019). Suspected neurological conditions: recognition and referral