Tics

What Is It?

A tic is a sudden, rapid, repetitive movement (motor tic) or vocalization (vocal tic). Motor tics usually involve muscles in a single location of the face or upper body.

There are two main types of tics:

• Simple tics involve one muscle group — for example, head shaking, eye blinking, sniffing, neck jerking, shoulder shrugging and facial grimacing.
• Complex tics involve more than one muscle group — for example, self-hitting or self-biting, jumping and hopping, and twirling while walking.

Tics sometimes evolve over time from one simple type of tic to another, or from a simple to a complex tic. In addition, some tics are slow and sustained rather than brief and rapid; some involve the lower body.

Vocal tics also can be simple (coughing, throat clearing, barking) or complex (repeating words out of context, echoing what someone else has said, uttering obscenities).

Tics are thought to be inherited neurological disorders that affect the body's motor system. They also can be caused by head injury or certain drugs, such as stimulants.

People with tic disorders describe an urge building up inside them before the tic appears. This build-up feeling is called a premonition. People with tics often feel relief after the tic is over. Although tics are involuntary, the urge sometimes can be suppressed for short periods with voluntary effort. A burst of tics often follows voluntary suppression, to relieve a buildup of the inner sensation. To get some idea of what this is like, try not blinking for as long as you can. You'll feel a "build up" sensation the longer you don't blink, and you'll feel great relief when you finally do blink.

When both motor and vocal tics are present and last for more than one year, the disorder is named Tourette's syndrome. A number of other disorders often occur along with tic symptoms. For example, more than 50 percent of people with Tourette's syndrome also have attention deficit hyperactivity disorder, while approximately 30 percent to 40 percent also have obsessive-compulsive disorder.

Symptoms

Typical symptoms of motor tics include involuntary (uncontrolled) muscular movements of the mouth or eyes, head twitching and shoulder shrugging. Examples of less common, complex tic symptoms are bending over to touch the floor, smoothing clothing or jumping.

Vocal tics are involuntary expressions, such as noises, words (sometimes obscenities) or repetitive phrases (in some cases with increasing rapidity).

Symptoms vary greatly among people with tic disorders, ranging from barely observable tics to severe and incapacitating symptoms. Fatigue, anxiety and other stressful events often make symptoms worse in people with tic disorders.