How to Deal with Movement Disorders in Children

Host: The term we use that is called movement disorders. What is that movement disorder? That is just all movement from one house to another? Henry Joseph Hasson: No, movement disorder is basically a disorder of movement, the abnormal movements in the body, that can be abnormal movements of the hand, abnormal movements of the face, and sometimes it's abnormally slow movements where you can't move as much as you want. Some times you are moving more than you like to. The way the brain works basically, it's usually on, it's always trying to move, and certain parts the brain control that by shutting off and preventing movement, and others parts of the brain are -- so some parts of the brain is trying to stop moving, some parts are trying to increase movement, and then we have a perfect balance of this in our brain, and when that balance is off, you can have a movement disorder, while you are moving not at will. Host: The big one everybody hears about, is what's called Tourette's syndrome. Is it very common in pediatric students? Henry Joseph Hasson: It depends, for me as a neurologist, it's very common, I see several a day, you know, definitely several a week. But it depends, you know, Tic disorders are definitely common in general, and by Tic disorder, we just mean any sort of repetitive, more fine movement, their repeats. Such as blinking your eyes like that or shrugging your shoulder. We have all seen in both children and adults that do things like that. Host: They just go away on their own, it's not a big deal, right? Henry Joseph Hasson: They don't often -- they don't always go on their on. Sometimes they are on a fix. Host: There are many that I've seen. Henry Joseph Hasson: Oh, yeah I mean many just do go away on their own, and lot of them are triggered by anxiety or stress, but sometimes it just it is genetic or environmental causes as well, and if it's just movement, we call it chronic motor Tic disorder, if it involves Vocal Tic, such as grunting or pain in the throat, and we will call it Tourette Syndrome at that point. Host: If a kid was diagnosed with Tourette syndrome, do you have to treat that? Or don't have to treat that? Henry Joseph Hasson: Yes, you don't have to treat it at all, specially since that treatment, usually don't help that much. Sometimes they are so much helpful. But usually they have a lot of side effect, and there is nothing dangerous or bad about having tic, as long as the child is coping with life just fine, and then we are okay. Sometimes they can be made fun of at school. It will cause some low self esteem and issues like that, in which case we might consider treating, but the first step which would be is to bring somebody into the classroom, a school psychologist, social workers, and teacher and talk to the other children, and lot of time that helps, and children understand that it's just an movement disorder and child is not crazy or has any other problems. They learn to really deal with that. Host: In fact, the kids are going to learn it at all, does it? Henry Joseph Hasson: No not at all. Host: So in other words, if he have it, he can live with that, it's get out of control. There are few medicines he can try to control. Henry Joseph Hasson: You know sometimes the tic can get so severe, that could be painful, or especially with their vocal tics where they are making a lot of noise and screaming, where this can disrupt the class or the social situation where the child is in, then you may want to treat them to help the child with that. The other thing is you know we are talking about Tourette syndrome and it's all feeling the tics. However you also have another Tourette often associated with either ADHD, Attention Deficit Hyperactivity Disorder or also associated with Obsessive Compulsive Disorder, OCP, and those may need to be treated even if you are not treating the tics. Host: Okay, but sometimes Tourette just goes away too, doesn't it? Henry Joseph Hasson: Yes, it can go away on it's own as well. Host: This is a nervous behavioral so they try to modify the kid? Henry Joseph Hasson: Not really, I mean a lot of parents get very upset and start yelling at their child, scolding their child, telling them to stop doing it, they think, they are doing at will, and especially since the child can't control it for a brief period of time, it makes people, such as the parents or others, think that it can be controlled and he is just doing it at will, but really as it is similar to an obsessive compulsive disorder, where you have this obsession to do it, and you feel a compulsion that you actually do the tic. You can't control it for a brief period of time, but then eventually because controlling the child we need to do it, no matter how much the parent yell at, and how much they punish him for that or any other behavior that can -- Host: So good parent, good understanding, good reinforcement, can help. Henry Joseph Hasson: That's all about education. Once the parents understand the disorder and learn about and read about, they will be able to help the child much better. Host: Is there any infection that can trigger up with tic disorder? Henry Joseph Hasson: That go controversial, there is something called Pediatric Autoimmune Neuropsychiatric Disorders (PANDAS), which you know we discussed in the past, and basically it's unclear. The problem is that a Strept that coccus infection of the throat, you know like a strept throat for example, is so common in children and Tourette is very common in children, that sometimes they could be associated and you see a lot of children have both, but it is not clear exactly what the association is right now. Host: So research is out. Henry Joseph Hasson: Yeah, a lot of research is going on on that.