Pediatric Presentation of Tics: Potential Role of TikTok
As reported by multiple news sites and academic articles, providers have noticed an increase in tic symptoms during the pandemic, particularly among adolescent girls. The tics mimic those seen in Tourette syndrome with an explosive onset and occurring about 29 times per minute. For context, Tourette syndrome is a neurodevelopmental disorder characterized by motor and vocal tics lasting at least one year in duration. The syndrome is relatively uncommon and 4 times more likely in boys than in girls, typically presenting between ages 5-7.
The causes of this sudden increase among teenagers are unknown, but it is possible that TikTok and other social media platforms have influenced this phenomenon. During the pandemic, tic-related content has gained popularity and by March of 2021 gained 5.8 billion views. Most children presenting now do not meet criteria for Tourette Syndrome. Their presentation is likely related to the stress of lockdown, changes in usual routine, and in some cases, the sense of connection and validation among the “Tic” or “Tourette” community on TikTok and other social media platforms. Teens who are prone to depression and anxiety are most likely to develop these functional tic-like behaviors as a way to release overwhelming stress.
It is important to remember that the initial approach to tics, when they do not interfere with function, is watchful waiting and psychoeducation for patients and caregivers. Screening for underlying anxiety or depression is essential. If Tourette Syndrome is suspected, consider that it is highly comorbid with ADHD and OCD. When treatment for tics is warranted, starting with behavior therapy may be sufficient, and when necessary, medication treatment can be helpful. Rarely do tic disorders warrant extensive bloodwork or other work-up. Call NC-PAL for medication recommendations or behavioral health resource referrals.
To read more about the phenomenon:
- Is TikTok Causing Tics in Teen Girls? What Parents Need to Know (Cleveland Clinic)
- COVID-19 related increase in childhood tics and tic-like attacks (Heyman et al., 2021)
- TikTok Tics: A Pandemic Within a Pandemic (Olvera et al., 2021)
- Rapid Onset Functional Tic-Like Behaviors in Young Females During the COVID-19 Pandemic (Pringsheim et al., 2021).
For more information on Tourette syndrome/Tic Disorders and treatment recommendations:
- Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders (Pringsheim et al., 2021)
- Clinical Features of Tourette Syndrome and Tic Disorders (Leckman et al., 2014)