Caregiver Corner: Paying Attention to Tics and Triggers

By Ian Hebeisen

Over seven years ago, my mom received a traumatic brain injury from a car accident. As a result, she sustained nerve damage that often leads to painful contortions in her arms and legs. At first, we couldn’t tell what would set off her arm spasms, but as time went on, we began to discover patterns and identify triggers.

One of her most notable contortions we lovingly refer to as “porging” – she’ll start to frown, putting on an expression that matches the “Porg” aliens from one of the most recent Star Wars movies. Her giant frowns typically occur after seeing a confusing image (lots of twisting shapes and lines, a dark and overly saturated picture, frightening imagery) or listening to dissonant music.

Auditory stimulation tends to be one of her biggest triggers. A sudden loud noise can send my mom into painful contractions, twisting her arms and flaring up the nerves in her legs. After a while, her muscles will calm down, but she can still be on edge for the rest of the day.

By looking at her triggers and the effect they have on my mom’s body, we can see the true interconnected nature of the nervous system. Admittedly, the relationship between triggers and the results can seem confusing at first – why would visual or auditory stimulation impact her control over her arms and legs?

My mom sat through many appointments with functional neurologists, including Dr. Paul Deglmann, DC, DACNB, FACFN. “He described a sort of metabolic threshold within my brain,” said my mom. “Whenever my brain crossed that threshold, it would trigger these symptoms.”

In a nutshell, after her accident, my mom’s brain developed a limit to the number of stimuli it could handle at once. Her nervous system pertaining to the five senses can only take in so much information. Once that part of the brain maxes out, it passes off the additional stress to other parts of the brain, usually ones that control the automatic processes in our body. This includes the medulla, which monitors functions such as breathing, heartbeat, blood flow, and so on.

The medulla already controls so much it overloads when it takes on additional stress. With both systems overloading – the sensory parts and the subconscious parts – the nerves take on the additional stress, causing painful spasming.

Her spasms demonstrate how closely related the systems of the brain are, and as a result, we’ve had to pay close attention to things we otherwise would not even consider. “It’s all about learning to stay within the threshold limit and managing my stressors and inputs,” said my mom.

We mainly look out for particular sounds and songs that trigger my mom. For example, when playing music aloud, we skip over songs with a heavy emphasis on offbeats (think back to the era of “ska” music). We also screen movies for her to make sure no scenes are overly stimulating. You remember that spooky tunnel scene in Willy Wonka and the Chocolate Factory? She would definitely need to close her eyes or risk being sent into spasm.

Through her various appointments, my mom built an arsenal of brain exercises to help her manage that threshold. In addition, different sets of eyeglasses aid in the amount of input she receives. She’s worn glasses with tinted lenses to reduce the amount of light intake, and now wears Brainwear® Glasses from the Mind-Eye Clinic.

Managing her symptoms remains an ongoing process, involving a lot of close monitoring of what triggers her spasms. Patience plays a big role in this, but so does attentiveness – if you notice some new tic or trigger developing, take note of it. Not only will it help you prevent a possible flare-up in the future, but might help a functional neurologist uncover the cause of an unknown symptom.