Tic Disorders and Tourette’s Disorder

Tics are sudden, brief and repetitive motor movements that can include spoken words (vocalisations) and sounds. 

• Motor Tics: Motor tics are movements of the body. Examples of motor tics include blinking, shrugging the shoulders, or jerking an arm.
• Vocal Tics: Vocal tics are sounds that a person makes with his or her voice. Examples of vocal tics include humming, clearing the throat, or yelling out a word or phrase.
  

Tics can be either simple or complex: 

• Simple tics. These sudden, brief and repetitive tics involve a limited number of muscle groups.
• Complex tics. These distinct, coordinated patterns of movements involve several muscle groups.
  

Tics typically develop between 4 to 6 years of age, and peak at between 10 to 12 years of age. Tics tend to decrease during the teenage years, and eventually most disappear on their own.

Categories of Tic Disorders:

• Provisional tic disorder: Motor and/or vocal tics have been present for less than 1 year
• Persistent tic disorder: Motor or vocal tics have been present for more than 1 year
• Tourette's disorder: Both motor and vocal tics have been present for more than 1 year

The diagnosis is made based on the history and physical examination. A tic disorder is diagnosed if the tics have been present before the age of 18. The tics must also not be due to the effects of drugs or another neurological condition.

There are no specific tests that are required to make a diagnosis of a tic disorder.

Tics can be associated with other mental health conditions such as Attention Deficit Hyperactivity Disorder, Obsessive Compulsive Disorder, Separation Anxiety Disorder, and learning disorders.

Treatment is aimed at reducing tics that interfere with everyday activities and functioning: 

• Behavioral therapy can reduce the number and severity of tics. Therapists provide education about tics, and teach relaxation techniques. Another useful coping strategy is habit reversal, in which a new action is performed to replace the tic.  
   
• There are several medications that can be used to help control tics or reduce symptoms of related conditions. Doctors will conduct a thorough evaluation and advise on whether medications would be helpful.

• Associate Professor John Wong Chee Meng
• Dr Celine Wong
• Dr Chee Tji Tjian