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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. Severe symptoms may significantly interfere with communication, daily functioning and quality of life.
Tics are classified as either:
- Simple tics, which are sudden, brief and repetitive, involving a limited number of muscle groups
- Complex tics, which are distinct, coordinated patterns of movements that involve 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.
| Common motor tics seen in Tourette syndrome | |
|---|---|
| Simple tics | Complex tics |
| Eye blinking | Touching the nose |
| Head jerking | Touching other people |
| Shoulder shrugging | Smelling objects |
| Eye darting | Obscene gesturing |
| Finger flexing | Flapping the arms |
| Sticking the tongue out | Hopping |
| Common vocal tics seen in Tourette syndrome | |
|---|---|
| Simple tics | Complex tics |
| Hiccuping | Using different tones of voice |
| Yelling | Repeating one's own words or phrases |
| Throat clearing | Repeating others' words or phrases |
| Barking | Using vulgar, obscene or swear words |
In addition, if you have Tourette syndrome, your tics may:
- Vary in type, frequency and severity
- Worsen if you're ill, stressed, anxious, tired or excited
- Occur during sleep
- Evolve into different tics over time
- Worsen during teenage years and improve during the transition into adulthood
Before the onset of motor or vocal tics, you'll likely experience an urge called a premonitory urge. A premonitory urge is an uncomfortable bodily sensation, such as an itch, a tingle or tension. Expression of the tic brings relief.
With great effort, some people with Tourette syndrome can 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 involuntary movements or sounds, schedule an appointment with your pediatrician. Not all tics indicate Tourette syndrome.
Many children develop tics lasting a few weeks or months that 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.
- Disorders usually first diagnosed in infancy, childhood, or adolescence. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed June 26, 2012.
- Jankovic J. Tourette syndrome. http://www.uptodate.com/index. Accessed June 25, 2012.
- Tourette syndrome fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm. Accessed June 25, 2012.
- Bloch MH, et al. Clinical course of Tourette syndrome. Journal of Psychosomatic Research. 2009;67:497.
- 5. Kurlan R. Tourette's syndrome. New England Journal of Medicine. 2010;363:2332.
- McNaught KS, et al. Advances in understanding and treatment of Tourette syndrome. Nature Reviews Neurology. 2011;7:667.
- Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. July 6, 2012.
- O'Rourke JA, et al. The genetics of Tourette syndrome: A review. Journal of Psychosomatic Research. 2009;67:533.
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