Tourette Syndrome (TS) is a neurological disorder characterized by tics – involuntary, rapid, sudden movements that occur repeatedly in the same way. The tics may occur many times a day nearly every day or intermittently. Tics periodically change in number and frequency, type and location and wax and wane in their severity. While some persons with TS have limited control of their symptoms from seconds to hours at a time, suppressing them may merely postpone more severe outbursts. Tics increase as a result of stress, anxiety, excitement and fatigue. They often decrease with relaxation or concentration on an absorbing task.
Things to know:
- Premonitory urges:
- Feeling an irresistible urge or tension before a tic
- Sensations such as itching, tingling, or tension
- Suppression:
- Some individuals with Tourette’s can suppress their tics for a period of time, but it often results in an increase in premonitory urges and a subsequent release of tics.
- Tic variability:
- Tics can change in frequency, intensity, and type over time.
- Tics may wax and wane, with periods of increased severity (exacerbations) and relative improvement (remissions).
- Association with specific situations or activities:
- Some individuals may notice an increase or decrease in tics during certain situations, such as stress, excitement, fatigue, or when engaged in specific activities.
It’s important to note that not everyone with Tourette’s syndrome experiences all of these symptoms, and the severity of symptoms can vary greatly from person to person.
Motor Tics
| Eye blinking | Clapping | Lip pouting | Skipping | Chewing on clothes |
| Eye rolling | Pinching | Lip licking | Stepping backwards | Kicking |
| Head jerking | Shoulder shrug | Tongue Thrusting | Walking on toes | Pulling at clothes |
| Facial grimaces | Knee Knocking | Hair tossing | Twirling | Somersaults |
| Facial contortions | Leg jerks | Arm flexing | Knee bending | Body slamming |
| Nose twitching | Stooping | Arm flapping | Foot tapping | Mouth stretching |
| Scratching Kissing Gesture | Jumping/Hopping Stomping | Abdominal jerking Tearing things | Foot shaking | Smelling fingers |
| Hitting self | Finger tapping | Squatting | Foot dragging |
Vocal Tics
| Throat clearing | Snorting | Whistling | Barking |
| Grunting | Squeaking | Hissing | Moaning |
| Sniffing | Coughing | Laughing | Saying words |
| Belching | Humming | Screaming | Clicking |
| Spitting | Yelling | Yelping | Gasping |
| Guttural sounds |
Complex Tics
Repeating phrases, words, parts of words; animal sounds; stuttering; amplitude of speech; muttering; Palilalia – Repeating one’s own words; Echolalia – Repeating other’s words; Coprolalia – using obscenities/socially taboo phrases.
OBSESSIVE COMPULSIVE DISORDER
Obsessions are repetitive, unwanted thoughts. Compulsions are repetitive, ritualistic acts that must be performed to rid oneself of the obsession.
Obsessions
| Concern for symmetry/order | Preoccupation with knives/blood, etc. |
| Concern for cleanliness | Worrying about harming self or others |
| Over focusing on minute details | Concerned about germs/dirt |
| Having to have “just right” feeling | Hoarding/collecting |
| Over focusing on moral issues | Thinking about forbidden behaviors |
| Over focusing on one idea/object | Mental coprolalia (Sexual thoughts/images) |
| Focusing on specific numbers | Aggressive thoughts/images |
| Needing to experience sensations | Obsessive fears |
Compulsions
| Adjusting clothing to feel just right | Licking self or others |
| Evening things up | Excessive hand-washing/bathing |
| Counting objects | Erasing repeating |
| Excessive Ordering/arranging/fiddling with | Touching objects, others, self |
| Checking & rechecking | Sexually touching self |
| Repeating actions | Picking skin/sores |
| Needing to say or do what told not to do | Cracking knuckles |
| Needing to start over if interrupted | Vomiting |
| Repeating the same question | Smelling hands or objects |
| Perseverating on a task | Not able to change tasks |
| Echopraxia (repeating the actions of others) | |
ADHD
- Often fidgets with hands/feet
- Difficulty remaining seated
- Easily distracted/Engages in physically dangerous activities
- Blurts out answers – loses everything
- Difficulty waiting turn
- Difficulty following through on instructions/organizing work. Shifts from one uncompleted task to another