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04 Jan 2005

facial tick
My husband and I are extremely concerned about our nine-year-old daughter. She recently returned from a trip with her grandparents to Cape Town displaying signs of what appears to be a facial tick. She is aware of making grimacing movements with her nose and mouth and says she is unable to control them. We have tried to reassure her that sometimes a facial muscle moves involuntarily and that we are there for her at all times. This manifestation has only been apparent for 10 days and initially we assumed it to be allergy related. We have treated our daughter with her regular antihystamine and nasal decongestant, but this has been to no avail. Most frustrating is that our GP, Paediatrician and ENT are all on annual leave. We are not certain where the best port of call thus is. In no way do we want to exaserbate the problem by placing too much emphasis upon it, but likewise we are concerned whether there are underlying causes that need attention. Would you know whether there is any medical urgency in exploring the root of this facial tick or would it be sufficiently responsible to await the return of our familiar doctors(another 10 days). Many Thanks, A concerned mom
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Expert
CyberShrink
cybershrink

01 Jan 0001

Dear jo,
Relax. Most tics are forms of habit, and this one might be related to her allergies, but more in the sense of her having got temporarily stuck on repeating a scrap of behaviour that at one time fitted her response to a blocked nose, or whatever, and now is being repeated even though it has no useful function. So it may no longer be relaed to the actual allergy itself, right now. For reasons that are usually never clear, some kids pick up one or other tic, at some stage in their lives, which generally stay a while and then depart about as mysteriously as they arived. They're rarely seen as medically urgent, except in the rare situation when they are just one of a number of symptoms suggesting some suddent neurological problem, such as headaches,, muscle weaknesses, and so on.
As Liza wisely points out, kids tend to pick up on our own anxiety, and anxiety almost always makes a tic worse. Generally, you ought to be fine waiting for the return of the doctors who know her already ( there's a significant advantage, outside of obvious emergencies ) to the opinion of a doctor who has known the person for longer, knowing more of their personality, history, and so on. So, unless more symptoms start to arrive as well as the tic, you should do fine to just take it calmly and see her GP / pediatrician when they return, making an appointment as soon as that's practical, mainly so as to re-assure yourself. If this continues to alarm you, you could try a different GP in the meantime, but she ought to be fine.
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