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

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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:

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