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What is a tic?

Tics are brief, sudden movements or sounds. They may happen at random times and many times each day. A tic is hard to stop, but you are awake and aware during a tic. Tics do not cause you to lose consciousness. 

There are two types of tics: motor tics and vocal tics. Motor tics involve movement of some part of your body. Vocal tics involve making some kind of sound with your mouth or vocal cords. Both kinds of tics can be either simple or complex

  • Simple motor tics involve a single group of muscles, such as the eyelid. 

  • Complex motor tics involve more than one group of muscles, such as the eyelid, cheek, and neck.

  • Simple motor tics are rapid motions. 

  • Complex motor tics are slower and seem to have a purpose. 

  • Simple vocal tics involve sounds which are not words and do not mean anything.

  • Complex vocal tics involve speaking words out loud.

Examples of motor tics include:

  • Nose wrinkling

  • Shoulder shrugging

  • Eye blinking

  • Frowning

  • Repetitive or obsessive touching

  • Head twitching

  • Kicking 

  • Jumping

Examples of vocal tics include:

  • Coughing

  • Hissing

  • Throat clearing

  • Barking

  • Grunting

  • Sniffing

  • Repetitive (unintentional) swearing 

Are the tics transient or chronic? 

Most people with tics have transient tics, which means that the tics last for a few days to months and then never come back. Tics that last for more than a year are called chronic tics. People with chronic tics have chronic tic disorder. Chronic tics can be either motor or vocal and can change over time. For instance, you can have a motor tic such as head twitches for many weeks, and then they go away. Then you might have a new motor tic like eye blinking or frowning.

What is Tourette Syndrome?

Tourette Syndrome is when you have both vocal and motor tics for more than a year. It can be mild or severe, and is treated the same way as other chronic tic disorders. 

What can make tics worse?

  • Feeling embarrassed about having tics. 

  • Feeling nervous about something like standing up and making a speech. 

  • Being tired or stressed. 

  • Getting sick. For some people, even a mild illness like a cold can make tics worse. Antibiotics can help you fight off a bacterial illness. They will not help a viral illness and will not stop tics once they start. See or call your doctor for advice if you think you have a bacterial illness.

How are tics diagnosed?

Tics are often straightforward to diagnose at a doctor’s visit. Your doctor might want to have some lab testing done to rule out other conditions that may look like tics but are not. These tests may involve checking your blood or a urine sample. You do not need to do a brain scan (MRI or CAT scan) if you have transient or chronic tics. 

Are tics bad for me?

No, tics do not damage your brain or make you any less smart. Some people have pain if the tic involves a violent motion, such as flinging your head to one side, or biting down on your own tongue or cheek. More often, tics can be a make you feel embarrassed. More so if you are a preteen or teenager. It is wrong to make fun of people with tics. If people do make fun of you, you can tell them that you do not have control over your movements. Most teachers are willing and happy to teach your peers about this. 

Will my tics go away? 

Many children who have chronic tics do outgrow them. About half of children with chronic tic disorder outgrow tics by early adulthood, and most of those who still have tics will notice a decrease in the severity of the tics. 

Treating tics with medicines (see next page) does not make the tics go away any faster, it just stops them for a while. It does not improve your chances of outgrowing them. 

Are there other conditions that come with tics?

Some children with tics will have problems with attention and hyperactivity. This is called attention deficit hyperactivity disorder, or ADHD. Others may have problems like excessive hand washing, compulsive touching, or repeated checking of doors or lights. This is called obsessive compulsive disorder, or OCD. Anxiety disorder is also common. For some children, these symptoms can be very upsetting and may need to be addressed by a psychologist or psychiatrist.

What is PANDAS? 

PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. The theory of PANDAS is that strep infections like strep throat can trigger and make worse your tics or symptoms of ADHD, OCD or anxiety (see paragraph above). Doctors do not agree on whether PANDAS really exists or what to do about it. Many doctors do not believe it really exists. Other doctors think that any kind of infection, not just a strep infection, can also trigger or worsen tics in some (not all) children. All doctors agree that most children with tics do not have PANDAS and many children with tics do not have more tics with infectious illnesses. Talk to your doctor if you have questions about this. 

Here are some tips to help with tics:

  • Don’t focus on the tic. Thinking about it makes it worse.

  • Avoid stress when you can. Give yourself plenty of time to get projects done so that you don’t make your tics worse by waiting until the last minute. 

  • Be sure to get enough rest. Not getting enough sleep can make tics worse. 

  • If you feel a tic coming on, let it go. Don’t hold back. If you try to hold it back, it will be much worse.

  • Don’t point out other people’s tics. If you do, it will embarrass them and make it worse.

Medicines

Your doctor or neurologist can prescribe medicine for you if the tics are painful or really embarrass you. Ask about possible side effects of each medicine to find the one that fits you best. Medicines may not make the tics go away completely. If your goal is that the tics go away enough to make you feel more at ease, taking medicines may be a good plan for you. 

Behavioral psychology may help reverse the behaviors of tics by teaching you:

  • To recognize when you are about to have a tic. 

  • How to train yourself not to go through with the tic. 

This kind of treatment can work as well as medicines but is hard and you need to practice a lot. Ask to see a behavior psychologist if you would like to try this treatment.

Deep brain stimulation is a treatment for very severe tics which do not respond to any other treatment. It is a surgery to implant an electrode deep in the brain. You need to have an extensive medical workup to decide if it is necessary and would be helpful for you. 

More information

Some websites you can check out include: