A tic is an abrupt, unintentional movement or sound, unrelated to environmental stimuli. From time to time, we all have tics — an unexplained spasm or an unconscious twitch — and usually they’re nothing to worry about. But when tics are severe or are repeated for days or weeks, they may be signs of a tic disorder, a motor disorder that usually (but not always) starts in childhood and improves over time.
Tics look different in everyone, and may change and morph in a single person periodically — meaning you or your child could have a repetitive eye twitch one week, and a throat-clearing tic the next. Tics can appear in any environment, but some people with tics (children especially) consciously suppress them in situations where the tic may cause embarrassment — at school, perhaps, or during an important meeting. Suppressing a tic takes effort, and produces a feeling of tension that can usually only be released by performing the tic.
Symptoms of Tic Disorders
Tics are divided into two types: motor tics and vocal tics, both of which are categorized as simple or complex.
Simple motor tics are brief motions generally completed in one movement, such as the following:
- Eye twitch
- Eye blink
- Jaw thrust
- Neck tilt
- Nose twitch
- Facial grimace
- Tightening of a single muscle (the abdomen, for example)
- Limb thrust
- Shoulder shrug
Complex motor tics comprise either a series of movements, or a movement that appears to have a specific purpose. Examples of complex motor tics include:
- Giving a “thumbs up”
- Giving “the finger” or performing another vulgar movement unintentionally
- Mimicking the movements of others
- Freezing briefly
- Series of movements that are always performed in the same order — a head twist followed by a shoulder shrug, for instance
- Self-harming movements — striking oneself in the face, for example
Simple vocal tics are short sounds that don’t sound like speech and last for just a moment or two — though they often occur in repeated bouts. Examples of simple vocal tics include:
Complex vocal tics sound more like regular spoken language and may include the following:
- Mimicking words said by others (known as echolalia)
- Unintentional obscene words or phrases (known as coprolalia)
- Repeating single phonemes (sounds) from a word
- Any other random words, said without intention to communicate
Sorting Out Symptoms
Based on the type and duration of your tic, a doctor will determine the proper tic disorder diagnosis.
The most common type is transient tic disorder, also known as provisional tic disorder. Transient tic disorder is diagnosed in children who have had tics for more than four weeks but less than a year. The tics can be motor, vocal, complex, or simple, and can occur by themselves or in concert with other tics — what’s important for this diagnosis is the length of time the tics have been present.
The next most common type of tic disorder is known as chronic tic disorder, which is diagnosed only if a child has had tics for more than a year. It could be one tic or several, but if more than one is present, all tics must be either vocal or motor.
If you or your child has multiple motor and vocal tics, all of which have lasted for more than a year and started before the age of 18, your doctor may diagnose you with Tourette Syndrome, the most severe form of tic disorder. Tourette is a well known condition, but it’s actually relatively uncommon: only about 200,000 people in the United States live with Tourette Syndrome.
If your symptoms don’t fit into any of the categories above, your doctor may diagnose you with tic disorder NOS (not otherwise specified). This diagnosis mostly applies to adults, since all the above diagnoses require symptoms to appear before the age of 18.