Tics & Tourette

Tourette Syndrome (TS) is a neurobiological condition characterized by involuntary movements and sounds, called tics.

What is tics?

Tics are repetitive, rapid, sudden, purposeless, arrhythmic, involuntary movements and sounds. Involuntary movements are called motor tics and involuntary sounds are called vocal tics.

Vocal tics are sounds produced by muscles in the throat, nose or vocal cords. Since tics can occur in nearly any part of the body and in any muscle, it is impossible to give a complete overview of all forms of tics.

A distinction is made between simple and complex tics.

Simple tics are restricted to one muscle or a single muscle group (e.g. eye blinking, nose twitching, tongue protrusion), simple, meaningless sounds (e.g. grunting, throat clearing, coughing, sniffling and barking).

Complex tics involves more muscle groups (e.g. repetitive touching of objects or people, repetitive obscene movements (copropraxia), mimicking others (echopraxia).
Complex vocal tics are words or phrases, expressing obscenities (coprolalia), repeating others (echolalia) or repeating oneself (palilalia).

Tics “vaxe and vane”

Tics changes unpredictable over time. New ones may appear and old ones may disappear, completely or for a period of time. Tics often move from one part of the body to another. This changes is often referred to as “wax and wane” in the literature. The pattern is unpredictable.
The time between each tic or series of tics can vary from seconds and minutes to hours and days.

The amount of tics can increase both with stress and at rest, and can decrease when concentrating on tasks and activities that require concentration and attention.
Tics can be exacerbated to varying degrees by, for example, anxiety, , nervousness, boredom, anticipation, lack of sleep, etc.

Tics can be present during sleep.

Various Tic disorders

Tourette Syndrome is one of several tic disorders.

Various Tic disorders Transient/ provisional tics
Tics are relatively common in childhood and usually resolve themselves after a period of time. Transient tics are motor and/or vocal tics that have not lasted more than one year. These often consist of blinking, grimacing and head tossing. This is also the reason why the diagnosis of TS cannot be made until tics have been present for at least one year.

Chronic Tic disorders
Chronic motor or vocal tics describes tics that have lasted for more than a year. Chronic vocal tics are relatively rare.

Tourette Syndrome
For the diagnosis of TS, at least two motor tics and one vocal tic must have been present (but not necessarily simultaneously) for more than 1 year. The tics shall have started before the age of 18. Tics do not have to cause disability for the diagnosis to be set.


The symptoms/ tics usually start in early childhood, around 5 years, but can occur both earlier and later than this.

The first symptoms are usually facial tics, such as excessive blinking or grimacing.Vocal tics ofte appears 1 or 2 years later than motor tics, and complex tics later than simple tics.

The severity of Tourette varies considerably from person to person. For most patients, the worst period of tics occurs between 8 and 12 years of age. In adulthood, tics tend to have a more stable course.

Most people experience a significant tic decrease and/ or become less bothered by their tics during adolescence. Nevertheless, some people with TS do not experience a this reduction in tic intensity, and some experience a severe and debilitating form of tic disorder.


Tourette Syndrome can not be cured and the aim of treatment is to reduce symptoms.

Co-occurring conditions and additional difficulties

Co-occurring conditions and other additional difficulties are common in Tourette syndrome. The most common in TS are ADHD, obsessive-compulsive disorder (OCD) and anxiety.

Sleep difficulties, sensory hypersensitivity, pain and behavioral problems are other additional difficulties that can occur.