Tic Info

WHAT IS A TIC?

 

 

A tic is a sudden, rapid, purposeless, repetitive, involuntary muscle movement (motor tic) or vocalization (vocal tic). "Simple" tics may include eye blinking, neck or shoulder jerking, sniffing, picking, grunting, barking, and chirping. "Complex" tics can include arm flapping, facial grimacing, coprolalia (the involuntary uttering of obscene words or phrases), palilalia (involuntary repetition of one's own words), and echolalia (involuntary repetition of another person's words or phrases). Despite broad publicity, coprolalia is rare and is seen in just 10% of people with tic disorders.

 

Tic disorders are categorized according to age of onset, severity, duration of symptoms, and presence of vocal and/or motor tics. However, distinguishing between one tic disorder and another can be very difficult and challenging.

 

Transient Tic Disorders typically begin in childhood and are seen in as many as 5% - 24% of school children. To receive a diagnosis, the individual must experience either single or multiple tics for at least 4 weeks, though for no longer than 1 year. Motor tics (i.e., eye blinking, grimacing) are more frequently observed than vocal tics (i.e., throat clearing). As with all tic disorders, transient tics tend to worsen during times of increased stress, excitement, or lack of sleep. Though an episode of transient tic disorder cannot last for longer than a year, children frequently have recurrent bouts of transient tics over time.

 

Chronic Motor or Vocal Tic Disorder differs from transient tic disorders in that chronic tics persist for more than one year. Single or multiple motor or vocal tics (though not both) must be present, and the onset of the illness must occur before the age of 18.

 

Tourette Syndrome Gilles de la Tourette Syndrome (otherwise known as Tourette Syndrome or TS) is a neurological disorder characterized by both multiple motor tics and at least one or more vocal tics, though both types of tics do not necessarily need to be present at the same time.

 

The first TS symptom seen is usually a facial tic (i.e., eye blinking, forehead furrowing). These tics are often replaced or added to by tics involving other parts of the body, including the neck, shoulders, trunk, and limbs. Sometimes the tics may become complicated and complex, involving the entire body, such as with kicking or twirling. TS sufferers often report feeling a "premonitory urge"- a strong and irresistible urge to perform a tic - followed by a momentary feeling of relief once the tic is performed. Other tics can happen without warning.

 

The symptoms of TS vary from person to person and range from very mild to very severe, although the majority of cases are mild. The disorder is usually chronic, and symptoms typically wax and wane, with a peak severity between the ages of 10 and 12. Associated problems may include impulsivity, attention difficulties (ADHD/ADD), learning disabilities, and obsessive-compulsive behaviors. There is typically a family history of tics, TS, ADHD, and/or obsessive-compulsive disorder (OCD).

 

HOW TO DETERMINE IF YOU MAY HAVE TOURETTE SYNDROME OR CHRONIC TIC DISORDER

 

If you answer yes to several of the following questions, you may have TS or chronic tic disorder. Please note that the questions can not provide you with a final diagnosis. If you suspect you may be suffering from a tic disorder, you should consult with a doctor for a diagnostic evaluation.

 

1. Have you ever had (or do you currently have) facial tics, jerking, or any other unusual body movements? (motor tics)
2. Have you ever made (or do you currently find yourself making) any involuntary noises or grunts? Or do you say words involuntarily? (vocal tics)
3. Have you found yourself performing these behaviors several times a day?
4. When did you first begin having the tic(s)? At least a year ago?
5. Has there ever been a period of time when you were tic-free for more than 3 months?

Medical conditions such as Huntington’s Disease and Postviral Encephalitis will rule out a diagnosis of TS or chronic tic disorder. TS and chronic tics first become evident between the ages of 2 and 15 and, in order to receive a diagnosis, symptoms must begin before the age of 18. Tic disorders impact all ethnic groups, and they affect males 3 to 4 times more often than females.

 

The Tic Disorders Clinic & Research Unit aims to inform the public, advance research, and provide state-of-the-art care and treatment for individuals with tic disorders.