Key takeaways
- Facial tics result from several different disorders, including provisional tic disorder, chronic motor tic disorder, chronic vocal tic disorder, and Tourette syndrome.
- Facial tics refer to uncontrollable movements in the face, including rapid eye blinking, nasal flaring, raising eyebrows, clicking the tongue, clearing the throat, grunting, nose scrunching, and opening the mouth.
- Depending on the severity of the facial tics, people may not require treatment for facial tic disorders. Treatment can include behavioral therapies, psychotherapy, and medication.
Facial tics are uncontrollable movements in the face, such as rapid eye blinking or nose scrunching. People may also call them “mimic spasms.” Although facial tics are usually involuntary, they may be suppressed temporarily.
A number of different disorders can cause facial tics. They occur
Facial tics can occur as the only type of tic you experience, or they may occur alongside tics that affect other areas of the body. You may experience isolated facial tics without a neurological disorder, or they can be part of a neurological disorder that also involves other symptoms.
The use of binary terms such as “male” and “female” or “men” and “women” in this article reflects the language of the sources we’ve used. Unless otherwise noted, it’s unclear whether the research we reference included participants with expansive gender identities.
Facial tics are a symptom of several different disorders. The severity and frequency of the tics can help determine which disorder is causing them.
Provisional tic disorder
Provisional tic disorder involves facial tics, vocal tics, or both, that last for less than 1 year. They may occur nearly every day for more than a month but typically improve over the course of a year. They generally resolve within a year without any treatment, but tics may still be present after a year in some instances.
This disorder is most common in children and is very similar to Tourette syndrome.
People with provisional tic disorder tend to experience an overwhelming urge to make a certain movement or sound. Tics may include:
- blinking eyes
- flaring nostrils
- raising eyebrows
- opening the mouth
- clicking the tongue
- clearing the throat
- grunting
- complex vocal tics, such as shouting, echolalia, and coprolalia (vocalizing of curse words)
Provisional tic disorder doesn’t usually require any treatment. However, doctors may recommend treatment if tics cause emotional or physical discomfort.
Chronic tic disorders
Chronic motor tic disorder involves only motor (movement based) tics that may wax and wane in frequency but
Excessive blinking, grimacing, and twitching are tics associated with chronic motor tic disorder. Chronic vocal tic disorder may involve tics like throat clearing, grunting, and clicking the tongue.
Tics tend to develop between ages 4 to 6 years and don’t typically require treatment. At that point, the symptoms may be manageable and can even subside on their own.
However, symptoms can peak between ages 10 to 12 years.
The specific treatment will depend on the severity of the tics and whether they cause distress.
Tourette syndrome
Tourette syndrome, also known as Tourette disorder, typically begins in childhood between the ages of
The tics can intensify and begin to affect other areas of the body as the disorder progresses. However, the tics usually become less severe in adulthood.
Tourette syndrome is a condition in which a person experiences multiple motor tics and at least one vocal tic, although not necessarily concurrently,
Tics associated with Tourette syndrome include:
- flapping arms
- sticking the tongue out
- shrugging shoulders
- coprolalia
People can usually manage Tourette syndrome with behavioral treatment, psychotherapy, and medication. However, if tic symptoms are mild, people may not require treatment.
Other conditions may result in facial spasms that mimic facial tics. They include:
- hemifacial spasms, which are twitches that affect only one side of the face
- blepharospasms, which affect the eyelids
- facial dystonia, a disorder that leads to involuntary movement of facial muscles
If facial tics start in adulthood, your doctor may suspect hemifacial spasms.
Several factors contribute to facial tic disorders. These factors tend to increase the frequency and severity of tics.
Contributing factors include:
Facial tic disorders
Your doctor can usually diagnose a facial tic disorder by discussing the symptoms with you and observing your symptoms.
It’s important to rule out other potential causes of facial tics. Your doctor may ask about other symptoms to decide whether you need further testing.
Sometimes, they
Your doctor might also want to perform an electromyography (EMG), a test that evaluates muscle or nerve problems. This is to check for conditions that cause muscle twitching.
Most facial tic disorders don’t require treatment. If your child develops facial tics, avoid drawing attention to them or scolding them for making involuntary movements or sounds. You can also help your child understand what tics are so they can understand what they’re experiencing.
Treatment may be needed
- stress reduction programs
- psychotherapy
- behavioral therapy, such as comprehensive behavioral intervention for tics (CBIT)
- dopamine receptor blocking medications, such as haloperidol, risperidone (Risperdal), and vesicular monoamine transporter 2 (VMAT2) inhibitors like deutetrabenazine (Austedo)
- antipsychotic medications like aripiprazole (Abilify)
- anticonvulsant topiramate (Topamax)
- alpha-agonists like clonidine and guanfacine
- medications to treat comorbid conditions, such as ADHD and OCD
- botulinum toxin (Botox) injections to temporarily paralyze facial muscles
A 2024 meta-analysis suggests that deep brain stimulation may help treat Tourette syndrome. Deep brain stimulation is a surgical procedure that places electrodes in the brain. The electrodes are placed in specific areas of the brain to adjust electrical patterns.
This type of treatment can help relieve symptoms of Tourette syndrome. Pre-surgical testing can help identify whether an individual who is experiencing tics would benefit from a surgical procedure.
Some limited research suggests that cannabis-based medications might also be effective in helping reduce tics. However, further research is necessary.
Additionally, the American Academy of Neurology guidelines state that cannabis-based medications should be avoided in children and adolescents, and pregnant people, people who are breastfeeding, and people with psychosis should not use them.
While facial tics usually aren’t dangerous, you may need treatment if they interfere with your everyday life.
If you’re concerned you or a child in your care may have a facial tic disorder, consider talking with your doctor about treatment options.