Tic disorders in children with frequent eye blinking

Purpose: To prospectively evaluate the significance of psychiatric consultation in children with frequent eye blinking. Methods: Fifty children < 16 years of age with frequent eye blinking underwent a psychiatric examination after undergoing a detailed ophthalmologic examination and receiving appropriate treatment. Patients with squinting related to intermittent exotropia or uncorrected refractive errors were excluded. The severity of tic symptoms and the differences in mothering behavior and childhood behavioral problems between the children with tic and normal children were assessed. Results: Tic disorders were diagnosed in 43 children: 39 had transient tic disorders, 2 had chronic tic disorders, and 2 had Tourette's syndrome. Ten patients had complex motor tics, and 4 had motor and vocal tics. Two children with Tourette's syndrome, and another 2 who returned to the clinic with aggravated symptoms after 6 months without any ophthalmologic abnormalities, were treated with psychiatric medication. There was no difference in mothering behavior or childhood behavior problems between the children with tic and normal children. The severity of tic was significantly correlated with the duration of tic symptoms, the score of somatic complaints, and attention problems. Conclusions: Most of the children with frequent eye blinking had a transient tic disorder. Tics become more severe with a longer duration of symptoms and may have influenced the somatic symptoms and the patient's level of attention. Psychiatric consultation may be necessary for children with long-standing and frequent eye blinking.