Functional Neurological Disorder: A Neurologist Explains Rise of Tics on Teenage Girls Since Pandemic

In a recent episode of Britain's Tourette Mystery, Scarlett Moffatt noted that many teenage girls had developed tics since the pandemic started. She suggested it could be due to watching too much social media.

Jon Stone, a consultant neurologist at the Royal Infirmary of Edinburgh and the University of Edinburgh, explained that the condition shown in the episode is more likely a functional neurological disorder (FND). He now describes the missing piece of the documentary and raised that it is dangerous to suggest that it could be acquired by watching social media,

Functional neurological disorder

In the particular Moffatt Investigates episode, it cited several teenagers with tics. She mentioned Echo, an 11-year-old who suddenly started jumping, twirling, clapping, and making noises. She would suddenly hit her mother and involuntarily call her "stupid motherfucker." She said she is having a "sudden-onset Tourette's." A few months after moving to a new school, her tics stopped.

The episode also featured Nicole, who developed a similar tic. Unfortunately, Nicole's tics have not improved, and she said it is "who I am now."

As per Stone, he has met people like Echo and Nicole, who experienced sudden onset of tics as a teenager. However, he clarified that the new tics in teenagers are hardly ever caused by Tourette's. He said that the tics are usually "functional tics," which are one of many possible symptoms of functional neurological disorder or FND.

Per Neuro symptoms, the neurologist described that the symptoms of FND include tremors, limb weakness, numbness or blackouts, and weaknesses. Since the condition does not show irregularities on scans or x-rays, the symptoms have been classified under "hysteria" or "psychosomatic." Health professionals tend to disregard signs of FND, which is why the condition remains hidden.

Stone said that FND could be considered when there is a particular movement of features of the tremors or seizures. It would eventually disappear when the patient is distracted or a leg weakness improves when the doctor uses specific techniques. People with FND are often defined as the "hardware" of the brain is fine, but the "software" has gone wrong.

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Different from Tourette

Stone noted that FND differs from Tourette's syndrome, adding that the developmental disorder began gradually in early childhood and is more common in boys. Meanwhile, FND typically starts rapidly and is more common in girls. But Stone said that girls could get Tourette's as well.

Functional tics can involve movements that can hurt another person, which is rare in Tourette's. Coprolalia, the medical term for swearing vocal tics shown in the program, is rare in Tourette's but is more common and frequent in tics, The Conversation reported.

Possible causes

According to Stone, it is a mystery why some people develop functional tics, as much as it is still a mystery why people get Tourette's. Some researchers have blamed Tiktok, claiming that some people who have functional tic may develop it by watching others. Stone said that while such can happen with FND, Tourette's is a developmental condition. Hence, it is unlikely. FND rarely has one cause, he added.

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