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Symptoms
By Mayo Clinic staffTics — sudden, brief, intermittent movements or sounds — are the hallmark sign of Tourette syndrome. Symptoms range from mild to severe and debilitating.
Tics are classified as either:
- Simple tics, which are sudden, brief and repetitive and involve a limited number of muscle groups
- Complex tics, which are distinct, coordinated patterns of movements involving several muscle groups
Tics involving movement (motor tics) — often facial tics, such as blinking — usually begin before vocal tics do. But the spectrum of tics that people experience is diverse, and there's no typical case.
| Some of the more common tics seen in Tourette syndrome | |
|---|---|
| Motor tics | |
| Simple tics | Complex tics |
| Eye blinking | Touching the nose |
| Head jerking | Touching other people |
| Shoulder shrugging | Smelling objects |
| Eye darting | Obscene gestures |
| Finger flexing | Flapping the arms |
| Sticking the tongue out | Hopping |
| Vocal tics | |
| Simple tics | Complex tics |
| Hiccuping | Using different voice intonations |
| Yelling | Repeating one's own words or phrases |
| Throat clearing | Repeating others' words or phrases |
| Barking | Using expletives |
Tics can vary in type, frequency and severity over time. They may worsen during periods of stress and anxiety, fatigue, illness, or excitement. They can occur during sleep. You'll likely experience an urge, called a premonitory urge, before the onset of motor or vocal tics. A premonitory urge is an uncomfortable bodily sensation, such as an itch, a tingle or tension. Expression of the tic brings relief.
Different tics may develop over time. Tourette symptoms are usually at their worst during the teenage years and sometimes improve during the transition to adulthood.
With great effort, some people with Tourette syndrome can sometimes temporarily stop a tic or hold back tics until they find a place where it's less disruptive to express them.
When to see a doctor
If you notice your child displaying unusual movements or behavior, schedule an appointment with your pediatrician. Not all tics indicate that someone has Tourette syndrome.
Many children develop tics that last a few weeks or months and then go away on their own. But whenever a child shows unusual behavior, it's important to have a medical evaluation to identify the cause and rule out serious health problems.
- Tourette syndrome. Centers for Disease Control and Prevention. www.cdc.gov/ncbddd/tourette/default.htm. Accessed Jan. 10, 2010.
- Jankovic, J. Tourette syndrome. http://www.uptodate.com/home/index.html. Accessed Jan. 11, 2010.
- Tourette syndrome fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm. Accessed Jan. 10, 2010.
- Tourette syndrome. Genetics Home Reference. http://ghr.nlm.nih.gov/condition=tourettesyndrome/show/print. Accessed Jan. 22, 2010.
- Cavanna AE, et al. The behavioral spectrum of Gilles de la Tourette syndrome. The Journal of Neuropsychiatry and Clinical Neurosciences. 2009;21:13.
- Tourette syndrome: Frequently asked questions. Tourette Syndrome Association. http://www.tsa-usa.org/Medical/Faqs.html. Accessed Jan. 22,2010.
- Conolea CA, et al. The influence of contextual factors on tic expression in Tourette's syndrome: A review Journal of Psychosomatic Research. 2008;65:487.
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