Tic, tic, Tic! Tics, Tic, Tic, TICs! Tics, tic, Tics, Tic, Tics, tic tic tic tic tic ic, Tics!

Tics are rapid, purposeless, unvoluntary, unrhythmic, repetitive, frequent, unwanted, and discrete muscle movements. Tics are typically classified as motor or vocal tics. Motor tics include blinking, neck rotation, torso twisting, jumping, toe flexing, and countless other movements. Vocal tics include numerous vocalizations including coughing, making a hum or grunt sound, and saying a word or phrase. 

Please consult with a neurologists specializing in tics if you are experiencing distress related to sudden and involuntary movements or vocalizations. It is important to have a comprehensive evaluation and proper diagnosis to proceed with effective care. Common tic disorders and their diagnostic criteria are described below:

Provisional Tic Disorder

• Patient has one or more motor or vocal tics.
• Tics are present for less than one year.
• Tics start before age 18.
• The tics are not due to a medication, other drugs, or a medical condition that can cause tics (for example, Huntington disease or postviral encephalitis).
• The patient has not been diagnosed with another tic disorder.

Persistent Tic Disorder

• The patient has one or more motor tics or vocal tics, but not both.
• The tics occur many times a day nearly every day or on and off throughout a period of more than a year.
• The tics start before age 18.
• The tics are not due to a medication, other drugs, or a medical condition that can cause tics.
• The patient has not been diagnosed with another tic disorder.

Tourette Syndrome (Tourette Disorder, Tourette's, TS)

• The patient has two or more motor tics and at least one vocal tic.
• The tics have been present for at least one year. The tics can occur many times a day (usually in bouts) nearly every day, or off and on for at least one year.
• The tics begin before age 18.
• The tics are not due to a medication, other drugs, or a medical condition that can cause tics.

It should be noted that tics related to Tourette Syndrome first occur in early childhood and then tend to last off and on for an extended time. Tics also start very gradually, with only one new tic emerging at a time. There is no sudden onset of multiple tics. 

Many people with Tourette Syndrome have co-occuring concerns including anxiety, depression, Autism, OCD, ADHD, gender dysphoria, dysgraphia, and difficulty with executive functioning tasks. There also is some correlation with  Body-Focused Repetitive Behaviors (BFRB) such as excessive nail biting or skin picking, and Functional Neurological Disorder (FND) such as tic-like behaviors. 

To learn more about Tourette Syndrome and other tic disorders, please visit the Tourette Association of America website.