A tic is defined as a sudden, rapid, recurrent, nonrhythmic, stereotyped movement or vocalization (DSM-IV).
Clinical features:
(1) age of onset 2-18 years of age, with mean age of 7 years
(2) both involuntary muscular movements (motor tics) and uncontrollable noises (vocal tics) present, although not necessarily at the same time
(3) tics tend to occur several times a day but may be intermittent. A tic-free period should not last > 3 months.
(4) symptoms tend to vary over time, and may show exacerbation by anxiety or stress
(5) symptoms disappear during sleep
(6) lasts > 12 months and is usually a lifelong condition
(7) obsessive compulsive behavior and/or attention deficit hyperactivity disorder may be present
(8) impairment in social, occupational or other areas of functioning
(9) other causes (stimulants, infection, metabolic conditions, etc.) excluded
Involuntary muscular movements include:
(1) fast eye blinking
(2) head jerking
(3) facial grimacing
(4) shrugging
(5) knee jerks
(6) grooming behaviors
(7) jumping
Uncontrollable noises may include:
(1) grunting
(2) snoring sounds
(3) sniffing
(4) throat clearing
(5) barking
(6) "odd" sounds
(7) echolalia (repetition of words spoken to the patient)
(8) coprolalia (obscene words out of context) or profanity
