What are the non-tic signs and symptoms 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...
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Answer

A number of non-tic symptoms are relatively common in patients with TS and are described briefly in the Table below.

Table. Symptoms of TS (Open Table in a new window)

Symptom

Description/Comment

Sensory hypersensitivity

Cannot stand to have wrinkly socks, cuts the tags off his or her shirts, refuses all but bland food, or becomes agitated in a visually complex environment

Learning disability

Approximately 20% in clinical samples, more closely associated with comorbid ADHD than with tics; also associated with male sex, earlier onset, severity, perinatal problems, and lower rates in family members [140]

School phobia

Can be an adverse effect of neuroleptic treatment

Complex socially inappropriate behavior

Insults, racial slurs, and paraphilias (or, more commonly, suppressed urges) are present in a large minority of patients with TS, associated with comorbid ADHD

Rage attacks

Sudden outbursts lasting approximately 5-30 min, usually in children or teenagers; inconsolable, unremitting violent frustration, commonly after being denied an unreasonable request; often followed by apparently sincere contrition and remorse

Insistence on sameness

Refusal to take a different route home or omit a step in a routine, even when hurried; often without a clear obsession or other obsessive-compulsive symptoms

Anxiety and depression

Common in patient samples but not clearly more common in the general TS population

TS with both OCD and episodes of mania

Surprisingly high rates of mania in patients with TS and OCD shown in at least 2 studies, management frequently difficult

ADHD = attention deficit hyperactivity disorder; OCD = obsessive-compulsive disorder.


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