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 Tourette's syndrome
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Movement Disorders

Additional information, publications and films can be obtained from:

Tourette Syndrome Association
42-40 Bell Boulevard
Bayside, New York 11361

Tourette Syndrome And Other Tic Disorders

Definitions of Tic Disorders

Tics are involuntary, rapid, repetitive, and stereotyped movements of individual muscle groups. They are more easily recognized than precisely defined. Disorders involving tics generally are divided into categories according to age of onset, duration of symptoms, and the presence of vocal or phonic tics in addition to motor tics.

Transient tic disorders often begin during the early school years and can occur in up to 15% of all children. Common tics include eye blinking, nose puckering, grimacing, and squinting. Transient vocalizations are less common and include various throat sounds, humming, or other noises. Childhood tics may be bizarre, such as licking the palm or poking and pinching the genitals. Transient tics last only weeks or a few months and usually are not associated with specific behavioral or school problems. They are especially noticeable with heightened excitement or fatigue. As with all tic syndromes, boys are three to four times more often afflicted than girls. While transient tics by definition do not persist for more than a year, it is not uncommon for a child to have series of transient tics over the course of several years.

Chronic tic disorders are differentiated from those that are transient not only by their duration over many years, but by their relatively unchanging character. While transient tics come and go - with sniffing replaced by forehead furrowing or finger snapping, chronic tics - such as contorting one side of the face or blinking - may persist unchanged for years.

Chronic multiple tics suggest that an individual has several chronic motor tics. It is often not an easy task to draw the lines between transient tics, chronic tics, and chronic multiple tics.

Tourette Syndrome (TS), first described by Gilles de la Tourette, can be the most debilitating tic disorder, and is characterized by multiform, frequently changing motor and phonic tics. The prevailing diagnostic criteria include onset before the age of 21; recurrent, involuntary, rapid, purposeless motor movements affecting multiple muscle groups; one or more vocal tics; variations in the intensity of the symptoms over weeks to months (waxing and waning); and a duration of more than one year.

While the criteria appear basically valid, they are not absolute. First, there have been rare cases of TS which have emerged later than age 21. Second, the concept of "involuntary" may be hard to define operationally, since some patients experience their tics as having a volitional component - a capitulation to an internal urge for motor discharge accompanied by psychological tension and anxiety. Finally, the diagnostic criteria do not adequately portray the full range of behavioral difficulties that are commonly observed in TS patients, such as attentional problems, compulsions, and obsessions.

Tourette's syndrome > 1 > 2 > 3 > 4

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