Tourette Syndrome (TS) tics are sudden, intermittent, repetitive, unpredictable, purposeless, nonrhythmic, involuntary movements or sounds. Tics that produce movement are called “motor tics,” while tics that produce sound are called “vocal tics” or “phonic tics.” Tics can be either simple or complex.
Simple motor tics involve one muscle group and include eye blinking, lip-licking, shoulder shrugging, and head jerking. Complex motor tics involve a coordinated movement produced by a number of muscle groups. For example touching objects, jumping or spinning around. Complex motor tics may also include imitating someone else’s actions or exhibiting inappropriate or taboo gestures of behaviours.
Simple vocal tics include sniffing, grunting, throat clearing, uttering single syllables (e.g. uh-uh-uh) and humming. Complex vocal tics include uttering linguistically meaningful utterances (words and phrases), or changing the pitch and volume of voice. Complex vocal tics may also involve repeating a phrase he/she has heard over and over (echolalia), repeating one’s own words or uttering obscenities or socially taboo phrases.
The most important thing to understand about the tics associated with Tourette Syndrome is they are the result of a neuropsychiatric condition. The sounds and behaviors are involuntary and are not being done by choice.
Tics can be troubling to individuals with TS. They can cause embarrassment and discomfort. In some cases, they can cause physical pain, such as headaches, muscle strain, or soreness. The disorder can be stigmatizing especially if the person with TS is in environments that do not support or tolerate anyone who may appear a bit different. Most parents of children with TS worry about the psychological impact of TS and how their child will be viewed by other children, by their teacher, and by society at large. They are concerned about teasing and bullying, about the ability to make friends, succeed at school and get and keep a job.
TS is a genetic condition, meaning it is passed on from parent to child. This does not mean that if someone has TS their son or daughter will also be born with TS. Studies indicate that a person with TS has between a 5-15% chance of having a child, sibling or parent with the condition.
The symptoms of TS usually begin in early childhood around age five, but may occur as early as age one or two, or as late as the age of 17. Typically the first tics to appear are facial tics like eye blinking, nose twitching, or grimacing.