Tourette syndrome is an extension of people who have either motor or vocal or milder tics where there are severe and ongoing tics of at least 12 months’ duration of both vocal and motor type. In a high percentage of cases the tics are associated with ADHD and other neurodevelopmental disorders. Whilst in many cases the tics are mild and disappear gradually with the onset of puberty, in other cases the tics can be extremely difficult to manage and may require medical treatment. In most cases not only the tics require management but also the ADHD and related difficulties.
Tics involve sudden, rapid, repetitive movements or vocalisations. They occur quite commonly in association with ADHD. They may be intermittent and frequently do not cause significant problems. A wide range of tics which may be simple or complex, can involve recurrent eye, face and shoulder movements. Vocal tics include recurrent sniffing, coughing, grunting, hissing, barking, yelping or humming and other noises. It can also include spitting. The site, type, frequency and severity often vary over a period of time.
Examples of simple motor tics include: head and should nodding and turning, finger tapping, wrist and finger flicking, leg twitching, foot stamping, should shrugging, eye rolling and blinking, mouth opening, tongue poking, face pulling, grimacing, arm and leg stretching.
More complex tics may involve grooming the hair or other parts of the body, touching objects or body parts, pinching or picking skin, retracing footsteps, copying others’ actions, various facial and other gestures, turning round in circles, doing deep knee bends, hopping, jumping, skipping or ride finger and hand gestures.
More complex vocal tics include swearing or repeating their own or other people’s words or phrases.
Tics can be made worse by stress and anxiety, and may fluctuate with the situation. They may come and go for months at a time. Some children “release” their tics once they come home from school, having been able largely to contain them during the school day. In rare instances, and if both vocal and motor tics are frequent, persistent and significant, then a diagnosis of co-existing Tourette’s Syndrome should be considered.
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