Tourette's and Tics

Question 1

What is Tourette’s syndrome?

Answer 1

Tourette’s syndrome is characterised by the development of tics that are persistent for over a year. Tics are involuntary movements or sounds that the child performs repetitively throughout the day. These tics become more prominent when the person is under pressure or excited. The person may describe an overwhelming urge to perform the tic. This urge increases the more they suppress it. They feel they need to complete the tic, often several times, to get relief from that urge. These feelings are called premonitory sensations.

Question 2

When do tics present?

Associated with?

Answer 2

Tics often present around or after 5 years of age. They can be associated with OCD and ADHD.

Question 3

Examples of simple vs complex tics

Answer 3

Examples of Simple Tics

Clearing throat
Blinking
Head jerking
Sniffing
Grunting
Eye rolling

Examples of Complex Tics

Performing physical movements, such as twirling on the spot or touching objects
Copropraxia involves making obscene gestures
Coprolalia involves saying obscene words
Echolalia involves repeating other people’s words

Question 4

Management of Tourette’s?

Answer 4

Usually tics will improve over time. Mild cases with no signs of underlying disease may only require reassurance and monitoring. Taking measures to reduce stress, anxiety and triggers can be helpful.

More severe or troublesome tics should be referred to a specialist. They may benefit from:

Habit reversal training
Exposure with response prevention
Medications may be tried in very severe cases, usually with antipsychotic medications

Co-morbid conditions such as OCD and ADHD may benefit from treatment.