What are the general features of tics in 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

Most tics are simple, meaningless movements. Tics are not entirely random, however, often involving elements of experience, practice, and social convention.

Echolalia or echopraxia (ie, imitation of another's speech or movements) occurs in as many as one third of patients. Seeing another person with tics with excessive blinking may induce a bout of blinking in someone who has not had that tic for years. Similarly, hearing about tics increases their severity.

Tics sometimes appear to recapitulate a new, voluntary behavior. One example is "air typing" as a complex tic after learning to touch type (observed in 2 unrelated individuals by one of the authors).

A man whose self-history was published in 1902 described his tics as often involving an urge to do just what was forbidden, such as "clucking" when told to be quiet in school. He compared his motor and vocal tics to a "desire for forbidden fruit". [142] Complex tics can include inappropriate activities such as touching a hot iron or a stranger's breasts.

As with most movement disorders, tics are worse at times of emotional stress and are diminished dramatically during sleep.


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