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If your child was recently diagnosed with Tourette Syndrome (TS), you probably feel a sense of relief at knowing there’s a reason for the uncontrolled movements and sounds, or tics, that they’re afflicted by — spontaneously and repeatedly.
You also probably want to understand as much as you can about the neurological disorder and its involuntary tics. Learning the difference between simple tics and complex tics, as well as how TS tics tend to evolve over time, is a good place to start.
With offices in The Woodlands, Katy, Sugar Land, and San Antonio, Texas, our team at THINK Neurology for Kids provides specialized care and support for children and teens living with TS in the Greater Houston area.
A short tutorial on Tourette Syndrome
Tourette Syndrome (TS) is a neurodevelopmental condition characterized by repetitive, involuntary movements and vocalizations called tics. TS is part of a larger group of tic disorders that can affect the developing nervous system.
Motor tics are spontaneous body movements; vocal tics are involuntary vocalizations and sounds. Motor and vocal tics are, by definition, uncontrolled: A child with TS can’t stop their tics from happening. TS tics can:
- Vary in type and nature
- Be very mild or intense
- Occur often or irregularly
- Come and go over time
TS onset typically occurs between the ages of 5 and 10, affecting more boys than girls. Kids with TS are more likely to have co-occurring neurobehavioral conditions like anxiety, attention-deficit hyperactivity disorder (ADHD), and learning disorders.
How TS tic symptoms are categorized
A TS diagnosis means that for at least one year, your child has exhibited two or more motor tics and at least one vocal tic. Tics may occur many times a day, once a day, many times a week, or on and off in “bouts.” All tics are classified by type:
Simple tics
Simple tics are abrupt, brief, and repetitive movements or vocalizations that involve only a few muscle groups. They’re more common than (and tend to precede) complex tics.
Simple motor tics
Examples of simple motor tics include head or shoulder jerking, shoulder shrugging, nose twitching, eye blinking or rolling, squinting, and grimacing. Motor tics tend to appear before vocal tics.
Simple vocal tics
Grunting, barking, hissing, coughing, sniffing, and repeated throat clearing are examples of simple motor tics.
Complex tics
Complex tics are specific, coordinated patterns of movement involving several muscle groups across various parts of the body. Because they’re more coordinated, complex tics can seem more deliberate or purposeful, rather than involuntary.
Although complex tics still involve repetition, the movement pattern is longer than with simple tics; in some cases, it may even look like normal activity.
Complex motor tics
A complex motor tic might involve facial grimacing, a head twist, and a shoulder shrug. Other examples include hopping, kicking, bending, or twisting, sticking out the tongue, touching objects or people, making rude gestures, and headbanging.
Complex vocal tics
Complex vocal tics include a child repeating their own words or phrases, repeating words or phrases others say (echolalia), or swearing or using vulgar language (coprolalia).
Understanding how TS tics can change
TS typically begins with mild, simple motor tics in the head and neck. Over time, it may spread to involve muscles in the torso, arms, and legs. Tics tend to be worse in the early teen years, gradually improving by the late teens or early twenties. Less often, tics persist into adulthood, and in some cases, worsen.
Tics can be triggered
Certain things may act like a “tic trigger.” For example, your child may repeatedly clear their throat after hearing someone else do so. You may also notice that your child’s tics are worse when they’re anxious or excited, and subside when they’re calm or focused on something of interest.
Tics may be outgrown
For many kids with TS, tics remain mild and aren’t too disruptive — meaning they don’t impair the child’s function or have a negative social impact. In such cases, treatment isn’t necessary; their tics will keep evolving, and they may eventually outgrow them.
Tics can be managed
For tics that do become disruptive, the first line of approach is comprehensive behavioral intervention for tics (CBIT). Tics emerge as an unpleasant urge or sensation in your child’s body that only the tic can relieve; CBIT teaches them to voluntarily move in response to that urge, and thereby suppress the tic. Medication is only considered if CBIT is unsuccessful.
Ready to learn more about TS tics? Schedule an appointment at THINK Neurology for Kids today.
Our expert team — including Shaun Varghese, MD, Cristina Marchesano, MD, Lorena Herbert, MD, Barbara Kiersz-Mueller, DO, Lauren Weaver, MD, Alicia Walls, MD, Sundeep Mandava, MD, Sherwin Oommen, MD, Robby Korah, FNP-C, Jennifer Duchaney, CPNP-PC, Tammy DeLaGarza, FNP-C, and Heather King, CPNP-PC — is here to help.