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Possible to control tics with training

DEAR DOCTOR K: My son jerks his neck constantly. Why does he have this tic? Is it dangerous? What can we do about it?

DEAR READER: Tics are upsetting – both to the person who has them and to the people who see them. We like to feel in control of our world. A sudden, uncontrollable, rapid repetitive movement (called a motor tic) says we’re not in control. Since your neck moves only when you want it to, it’s disturbing to see your son doing something you know you could control. You can, but he can’t.

Neck jerking is a common tic. Other kinds of tics include sudden, uncontrollable sounds or vocalizations (vocal tics), eye blinking, sniffing and throat clearing.

Tics are thought to be inherited neurological disorders that affect the body’s motor system. They also can be caused by head injury or certain drugs, such as stimulants. Many kids with tics lose them by the time they are young adults. Hopefully, that will be true of your son.

People with tic disorders describe an urge building up inside them before the tic appears, followed by a feeling of relief after the tic is over. After making an effort to suppress a tic, the person usually has a burst of tics to relieve a buildup of the inner sensation.

If your son is disturbed by his tics, psychological counseling and behavior training can be effective. For example, a child may be taught to recognize that a tic is beginning and perform another movement that is incompatible with the tic.

Some people have severe tics that cause them to hurt themselves, by hitting or biting, for instance. Severe tics can be treated with medications that affect certain chemical messengers in the nervous system. A number of other medications, including injections of botulinum toxin (Botox and others), also may be effective.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.