Tics and Tourette Syndrome
Sudden, repeated movements and sounds, including Tourette syndrome
Quick Facts
- Type: Neurodevelopmental movement disorder
- Main feature: Involuntary tics (movements or sounds)
- Usually begins: Childhood, around ages 5 to 10
- Outlook: Often improves through the teen years
Overview
Tics are sudden, rapid, repeated movements or sounds that a person makes involuntarily. Motor tics involve movements, such as eye blinking, shoulder shrugging, or head jerking, while vocal tics involve sounds, such as throat clearing, sniffing, or grunting. Many children have mild, temporary tics that come and go.
Tourette syndrome is a specific tic disorder diagnosed when a person has both multiple motor tics and at least one vocal tic that have persisted for more than a year, beginning before age 18. Tics usually start in childhood, often peak in the early teen years, and frequently lessen or resolve in adulthood. Although tics can be frustrating, many people manage them well, and treatment is available when tics interfere with daily life.
Symptoms
Tics vary widely from person to person and can change over time. They are usually grouped as simple or complex.
- Simple motor tics: Eye blinking, facial grimacing, shoulder shrugging, head jerking
- Complex motor tics: A series of movements, such as touching objects or jumping
- Simple vocal tics: Throat clearing, sniffing, grunting, coughing
- Complex vocal tics: Repeating words or phrases
Many people feel a building urge or sensation before a tic, which is temporarily relieved by performing it. Tics can often be briefly held back with effort, but this is tiring. Stress, excitement, and tiredness tend to make tics more frequent. Contrary to a common belief, involuntary swearing is rare in Tourette syndrome.
Causes
The exact cause of tics and Tourette syndrome is not fully known, but they are understood to be neurodevelopmental conditions involving the brain's movement-control circuits.
- Genetics: Tics and Tourette syndrome often run in families.
- Brain differences: Differences in brain regions and chemical messengers that regulate movement.
- Developmental factors: Possible influences during early brain development.
Tics are involuntary and are not caused by bad behavior, poor parenting, or a person trying to get attention.
Risk Factors
- A family history of tics or Tourette syndrome
- Being male, as tics are more common in boys
- Other neurodevelopmental conditions, such as ADHD or obsessive-compulsive disorder, which often occur alongside tics
Diagnosis
There is no single test for tics or Tourette syndrome. Diagnosis is based on the history and observation of the tics. Evaluation may include:
- A detailed history of the type, frequency, and duration of tics.
- Confirming the pattern: For Tourette syndrome, both motor and vocal tics lasting more than a year, beginning before age 18.
- Screening for related conditions, such as ADHD, anxiety, or obsessive-compulsive disorder.
- Tests only if needed to rule out other causes when the picture is unusual.
Treatment
Many people with mild tics do not need treatment. When tics interfere with daily life, several options can help.
- Education and reassurance: Understanding tics, and informing teachers and family, reduces stress and stigma.
- Behavioral therapy: Comprehensive behavioral intervention for tics, including habit-reversal training, helps people manage the urge and reduce tics.
- Medication: For more troublesome tics, certain medications can lessen their frequency or intensity; a specialist weighs the benefits and side effects.
- Treating co-occurring conditions: Managing ADHD, anxiety, or obsessive-compulsive disorder often improves overall well-being.
Because tics commonly wax and wane and often improve with age, treatment is tailored to how much the tics affect daily life.
Prevention
- Tics cannot be prevented, but stress reduction can lessen how often they occur
- Ensure adequate sleep and manage fatigue
- Create a supportive, low-pressure environment at home and school
- Address co-occurring conditions such as ADHD or anxiety
- Avoid drawing excessive attention to tics, which can increase stress
When to See a Doctor
See a doctor if tics are frequent, interfere with daily life, cause pain or distress, or are accompanied by other concerns such as attention or mood difficulties. Also seek evaluation if:
- Tics appear suddenly and severely in an unusual pattern
- Tics cause injury or significant social or school problems
- A child is struggling emotionally because of the tics
- You are unsure whether a movement is a tic or something else
Frequently Asked Questions
What is the difference between tics and Tourette syndrome?
Tics are sudden, repeated movements or sounds and are common in childhood. Tourette syndrome is a specific tic disorder diagnosed when a person has both multiple motor tics and at least one vocal tic that have lasted more than a year, beginning before age 18.
Do people with Tourette syndrome swear involuntarily?
Involuntary swearing is actually rare in Tourette syndrome, affecting only a small minority. Most tics are far more common things like eye blinking, throat clearing, or head movements. The popular image of constant swearing is a misconception.
Can tics be controlled?
Many people can briefly hold back a tic with effort, but this is tiring and the tic usually returns. A therapy called habit-reversal training teaches strategies to manage the urge and reduce tics. Tics also tend to lessen with age for many people.
Do tics get better over time?
Often, yes. Tics usually begin in childhood and frequently peak in the early teen years, then lessen or resolve in adulthood for many people. Some continue to have tics as adults, but they are often milder and more manageable.
References
- Centers for Disease Control and Prevention (CDC). Tourette syndrome.
- National Institute of Neurological Disorders and Stroke (NINDS). Tourette syndrome.
- MedlinePlus, U.S. National Library of Medicine. Tics and Tourette syndrome.
- American Academy of Neurology. Tic disorders.