Increased risks of tic disorders in children with epilepsy: A nation-wide population-based case-control study in Taiwan.
Epilepsy raises tic risk almost nine-fold, so BCBAs should watch for new motor or vocal tics in these clients.
01Research in Context
What this study did
Researchers tracked every child in Taiwan who had epilepsy. They matched each child with a kid of the same age and sex who did not have epilepsy. Then they watched both groups for three years to see who developed tics.
The study used insurance records, so no one was missed. It was big enough to spot even small jumps in risk.
What they found
Kids with epilepsy were almost nine times more likely to get a tic disorder. Most new tics showed up within the first three years after the epilepsy diagnosis.
The risk stayed high even after the researchers ruled out other brain conditions.
How this fits with other research
Wong et al. (2016) ran the mirror study the same year. They found kids with Tourette syndrome were 18 times more likely to develop epilepsy. Together, the two papers show the link runs both ways.
Şahin et al. (2026) looked at teens with epilepsy and found they also show more autism traits and rigid thinking. The picture is bigger than tics—epilepsy flags a wide neurodevelopmental watch list.
Goodwin et al. (2012) used a different method and found clusters of kids with both ASD and epilepsy. The clusters had unique repetitive behaviors. The message: once epilepsy is in the mix, screen for several co-occurring conditions, not just one.
Why it matters
If a client has epilepsy, add a quick tic check to your regular assessment. Look for eye blinks, throat clearing, or small jerks. Early catch means early behavior plans and less stigma for the child.
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02At a glance
03Original abstract
Both epilepsy and tic disorders may share common mechanisms with the involvement of abnormal cortical-basal ganglion circuit connection and dopaminergic dysfunction. However, the association between epilepsy and tic disorders has never been studied. This study investigated the risks of developing tic disorders among children with epilepsy using databases of a universal health insurance system in Taiwan. The data analyzed in this study were retrieved from the National Health Insurance Research Database in Taiwan. The study cohort included children with epilepsy between 2001 and 2007 (n=2629) and a three-fold age- and gender-matched controls (n=7887). All subjects were followed up for 3 years from the date of cohort entry to identify their admissions due to tic disorders (ICD-9-CM codes 307.2, 307.20-307.23). Cox hazard regression analysis was performed to estimate the effect of epilepsy on the occurrence of tics. The epilepsy cohort had a higher prevalence of tics (1.7% vs. 0.2%), and a 8.70-fold increased risk of developing a tic disorder compared with the controls (adjusted hazard ratio (AHR) 8.70, 95% confidence interval (CI) 4.26-16.37, p<0.001). Male patients were observed to have a higher risk of developing a tic disorder (AHR 1.90, 95% CI=1.04-3.46, p<0.001) compared to female individuals. Patients with multiple antiepileptic drugs treatment also exhibited higher crude OR for developing tic disorders. This nationwide population-based cohort study, for the first time, demonstrated that there is a significantly increased risk for tic disorders among children with epilepsy. We also found males, attention deficit disorder and the use of multiple AEDs to be independent risk factors of tic disorders. Closely evaluating possible tic disorders would be crucial for improving the outcome and life quality in children with epilepsy.
Research in developmental disabilities, 2016 · doi:10.1016/j.ridd.2015.10.019