Overview of Tics
Tics are abrupt, involuntary, repeated movements (motor tics) or vocalized sounds (vocal or phonic tics). They usually develop during childhood and may gradually disappear with time or persist into adulthood. Their nature, severity, and frequency vary from case to case.
With effort, tics can usually be suppressed for short periods of time. They tend to become more pronounced during periods of stress or excitement and disappear when the person is distracted or deeply absorbed.
The most common and severe condition that causes tics is called Gilles de la Tourette syndrome. More common among boys than girls, Tourette syndrome is usually a lifelong illness that normally begins before the age of 21. It is characterized by frequent, multiple motor and vocal tics that may wax and wane throughout the course of the illness. Tourette syndrome may also be accompanied by behavioral disturbances such as obsessive-compulsive disorder, attention and learning difficulties or sleep disorders. Treatment of tics varies considerably depending on the nature and severity of the individual case. Mild cases require no treatment or can be treated with behavioral therapy. Tics that cause discomfort or embarrassment, or that otherwise interfere with daily life, may be treated with one of several drugs. Tourette syndrome usually requires lifetime drug treatment.
What Causes Tics?
- The cause of simple tics is unknown. They may develop as a means of relieving psychological tension.
- Tourette syndrome is usually genetically inherited.
- Stress, excitement and fatigue can worsen tics.
Symptoms of Tics
- Repetitive movements or sounds, usually first appearing during childhood. Motor tics usually involve one or more muscle groups in the face, shoulders or arms, but other parts of the body may be affected. They may be simple (blinking, raising the eyebrows, nose or mouth twitching, head turning, shoulder shrugging, or a specific facial grimace) or complex (leg kicking, jumping, touching someone or something, tapping or socially inappropriate gestures). Vocal or phonic tics also vary in complexity from sniffing or throat clearing to echolalia (compulsive repeating of words or phrases uttered by other people) or coprolalia (compulsive swearing and repeating vulgar phrases).
- Symptoms of Tourette syndrome: multiple, complex motor tics; grunting, barking, or coprolalia; obsessive-compulsive behavior, poor attention span, learning difficulties and sleep disorders.
- There is no known way to prevent tics or Tourette syndrome.
Diagnosis of Tics
- Medical history and physical examination are needed.
How to Treat Tics
- In people with simple, transient tics, symptoms usually disappear without treatment within one to several years.
- Mild cases may be treated with behavioral therapy, during which the patient learns to control the tic.
- Drug therapy is indicated in more severe, persistent cases (such as Tourette syndrome) when tics cause physical or social discomfort. Several types of medications can be effective, including anticonvulsants, antipsychotics, tranquilizers, antidepressants and the antihypertensive drug clonidine. These are all powerful drugs that may produce bothersome side effects.
When to Call a Doctor
- If you or your child develops a simple tic or multiple tics, make an appointment with a doctor. You may be referred to a behavioral therapist or other specialist for further examination or treatment.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media