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Anxiety and Stress Disorders (Children)

When to Seek Consult



When should I seek consult of a pediatric neurologist for tics?. My son is 8 years old and twitches his nose at times. He also makes grunting noises which can last 45 min. straight. No other signs of respiratory distress are seen. His pediatrician prescribed allergy meds for 2 weeks with no decrease in symptoms. These behaviors do not seem to bother my son. I am afraid his symptoms could be Tourette Syndrome.


If vocal or tic symptoms continue for at least 1 year and they are impairing to any degree, one should seek a neurologic opinion. Typically impairment does not appear until 2-3rd grade when the child would distract others in school, or be made fun of by the other students, or if it impairs the child`s self esteem or social functioning. Social functioning is often impervious to damage until either the tics are more robust, or the peer situation becomes more acute for the child. 

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Response by:

Floyd R Sallee, MD
College of Medicine
University of Cincinnati