Tic Disorders

Tics are movements or sounds that are repeated over and over that a child cannot control, such as throat clearing and eye squinting. Tics usually last less than a year, and often become worse when a person is stressed, tired or anxious. Tic disorders are substantially more frequent in boys than in girls, and a family history of tics is common.

A tic disorder that includes at least one vocal tic and lasts for more than a year is considered Tourette syndrome. Tourette syndrome is an inherited neurological disorder, with symptoms generally appearing before age 18

What are the symptoms of tic disorders?

There are two categories of tics:

  • Simple tics. Simple tics are sudden, brief movements that involve a small number of muscle groups, often around the head and neck. They occur in an isolated fashion, and are often repetitive. Some of the more common examples of simple tics include eye blinking, shoulder shrugging, facial grimacing, head jerking, yelping and sniffing.
  • Complex tics. Complex tics are distinct, coordinated patterns of successive movements involving several muscle groups. Complex tics may include jumping, smelling objects, touching the nose, touching other people, shouting obscenities, echoing the words of other people or self-harming behaviors.

Tics associated with Tourette syndrome tend to worsen in stressful situations. However, they improve when the person is relaxed or absorbed in an activity. In most cases, tics decrease markedly during sleep. Symptoms may subside for weeks or months at a time, and recur later.

Other problems associated with tic disorders can include:

  • Obsessive-compulsive disorder. The person is compelled to perform certain tasks repeatedly (e.g., washing hands or checking that a door is locked).
  • Attention deficit/hyperactivity disorder. The individual has difficulty concentrating, is easily distracted or has overly impulsive behavior.
  • Learning disorders. This includes problems with reading, writing, math and perceptual difficulties.
  • Sleep disorders. These include frequent awakenings or talking in one’s sleep. Learn more about sleep disorders.

How are tic disorders diagnosed?

When diagnosing tics, the major features that distinguish tics from other movement disorders are the sudden, rapid and temporary nature of the movement, and with the lack of an underlying neurological disorder; their repetitiveness; their disappearance during sleep; and the ease with which they may be voluntarily reproduced or suppressed.

Neuroimaging studies such as magnetic resonance imaging (MRI), computerized tomography (CT), electroencephalography (EEG) or certain blood tests may be used to rule out other conditions that could mimic Tourette syndrome.

How are tic disorders treated?

A combination of psychological therapy and medication has been found to be an effective treatment for tic disorders.

Our pediatric psychologists use behavioral modification therapy to help a child learn how to suppress or release a tic at the appropriate times. A psychologist can also help a child maintain self-esteem when tics interfere with social situations, and relaxation techniques and biofeedback may be useful in alleviating stress, which can worsen the symptoms.

Although medications are available to reduce specific symptoms, there is no one medication that is helpful to all patients with tic disorders. Since all medications have side effects, their usefulness must be weighed against problems they may cause. Your child’s neurologist or doctor can help you find the best treatment options.

Reviewed by Grace Mucci, MD, Aug. 31, 2015.

Children and Tics

In this segment from American Health Journal, Mary Zupanc, MD, provides background on what a tic is and explains the different types of tics.

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