TICS developed in 4 year old DD

[mummyeam]

Hi

I’m wondering If anyone can help or give some advice/reassurance.

My DD has started with what I’m certain are tics.

She has been clearing her throat (like a grunt) since February following a number of viral/bacterial tonsillitis. Only recently I began to think it may be a tic rather than related to her throat.

She has in the last 2 weeks began blinking and also in the last 2/3 days developed a humming sound.

The grunting is worse after food but is all day and the humming and blinking is worse when watching TV but again is all day.

I’m really worried that she is doing all 3 at once.

She is clever and funny but does appear to be a little more clingy to me and her Dad in the last couple of weeks and I’m not sure if that is in relation to c19 etc. She isn’t seeing her family or friends and usually is a sociable child so it’s a big change for her.

I feel really anxious about it and am watching her constantly to see if she’s doing it.

I feel so worried about it

Hopefully it's just a bad habit developed after having throat infection. I would definitely talk to your GP though, and I would also ask them about PANDA as a possibility (but be aware they may not have heard of it as not all doctors seem to have).

Do look it up for more thorough info, but in brief it is when a child develops psychiatric symptoms, often tics, following a strep infection. It can be treated with antibiotics so is not a disastrous diagnosis. The main issue seems to be recognising that is what's going on. That's not to say it IS this by any stretch, but it's something you want investigate and hopefully eliminate as a possibility.

Thank you.

I rang my GP on Wednesday and I mentioned PANDA but they didn’t seem to fully understand it. She advised me they can’t do anything until it’s been a few months. She’s had reoccurring throat issues which I spoke to ENT about today but the blinking and humming now make me think it’s more likely to be Tics or like you say panda.

Thank you for your advice :)

Sounds like you're on the ball in terms of what to keep an eye on.

Can you be really clear (but not rude or pushy!) with the GP again-

"I know we talked about PANDA last time but I'm not happy with how the conversation ended. My understanding is that this is a syndrome that occasionally occurs following a strep infection and causes rapid onset psychiatric symptoms. As far as I can see this fits well with what I am seeing in x, which do not appear to be classical slow-onset OCD/tic symptoms. I am concerned that she is not being considered for treatment with antibiotics as this is the recognised necessary treatment if PANDA were the problem. I hope that you are correct but would appreciate if you could please explain why you feel that her symptoms do NOT fit with the PANDA diagnostic criteria, and refer me to some literature to put my mind at ease."

If your GP is right and has good reason to disregard PANDA then they should be able to reassure you properly rather than just dismiss your concerns without explaining why. If not, then it's probably worth speaking to a different GP who will listen to your concerns properly, talk their thinking through with you, and either test/refer if they think PANDA, or actually explain to you why PANDA is not the problem here.