When is the typical onset of Tourette syndrome (TS) and other tic disorders?

Updated: May 30, 2019
  • Author: William C Robertson, Jr, MD; Chief Editor: Stephen L Nelson, Jr, MD, PhD, FAACPDM, FAAN, FAAP  more...
  • Print

By definition, TS has onset in childhood (usually age 5-10 y). The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Text Revision (DSM-IV-TR) requires onset before age 21. A multicenter study of German families showed that this definition is arbitrary but reasonable. In relatives of TS probands who also had tics, the tics usually started when the individual was younger than 18 years, but 5 relatives had otherwise typical histories for TS with onset after the age of 21 years. [133]

One study of a birth cohort with TS showed that the most common age for tic onset was 9-14 years. [134] The CDC found that diagnosed TS is approximately twice as common in persons 12-17 years old compared with those 6-11 years old.

The modal age of symptom onset increases roughly with complexity: Simple tics are reported earliest in life, while complex tics, compulsions, obsessions, and sensory tics, and/or premonitory sensations tend to develop somewhat later. Generally, simple motor tics (eg, blinking) are first noticed when the individual is approximately 5-10 years old, with vocal tics starting at 8-15 years.

Fortunately, by age 18 years, approximately 50% of patients are essentially free of tics. Tic severity tends to peak in early to mid adolescence and wanes thereafter. Tics may persist into adulthood but their severity is almost always diminished.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!