blepharospasm in adults - NICE guidance - suspected neurological conditions - recognition and referral
Last edited 05/2019
Tics and involuntary movements in adults
Summary points from NICE guidance relating to tics and involuntary movements in adults are:
Tics
- do not routinely refer adults with tics (involuntary movements that can
be temporarily suppressed at the expense of mounting inner tension) unless
the tics are troublesome or accompanied by additional progressive neurological
symptoms
- consider referring adults with a tic disorder for psychological therapy
if the disorder distresses them
- consider referring adults who have completed psychological therapy for a
tic disorder to have a neurological assessment if their symptoms are severe
and the disorder continues to distress them
- however inform the person that: there are not many medicines available to treat a tic disorder the medicines that are available don't always work well and can have serious side effects.
Involuntary movements
Do not routinely refer adults with isolated involuntary movements of the eyelid unless the movements:
- cause involuntary tight eye closure of both eyes (blepharospasm) or
- have persisted for more than 3 months.
In adults with involuntary movements of the face, neck, limbs or trunk that cannot be temporarily suppressed by mental concentration:
- refer for neurological assessment or
- refer to neurology or an eye clinic, according to local provision, if the person has involuntary tight eye closure of both eyes (blepharospasm).
Do not routinely refer adults with small involuntary muscular twitches (fasciculations) unless these are associated with muscle wasting and weakness or muscle rigidity.
Reference: