Tics are sudden, repetitive, non-rhythmic, stereotypical movements, gestures, or vocalizations. Tics are the most common movement disorder of childhood. The incidence of motor and/or vocal tic in school-age children varies between 5-20%. Motor tics usually appear at the age of 3-8 years (2-18 years) in the form of blinking or other facial tics. Motor tics are usually located in the face, head and neck region. Vocal tics usually appear a few years after motor tics (at the age of 9-10 on average) in the form of sniffing or throat clearing attacks. The onset of tics before the age of 18 is accepted by definition.
Motor and vocal tics usually increase with anxiety, tension, excitement, stress, the use of certain drugs, infections, hot weather and fatigue… while they decrease during sleep, when concentrating on a loved one or when the person feels relaxed… and / or they disappear. The intensity and severity of tics may increase in situations such as intense emotional arousal and exciting events, the start of school, birthdays, and upcoming holidays. The fluctuating course of tics is usually the fastest at the age of 10-12 years. This level decreases with the 20s after adolescence. Co-occurring developmental and mental disorders, poor family support, substance use such as cocaine, chronic diseases, etc. can be counted among the factors that worsen the course.
Transient tic disorder
Single or multiple motor and/or vocal tics occur multiple times a day, nearly every day for at least four weeks, and these tics do not persist for more than one year.
Chronic vocal or motor tic disorder
Single or multiple motor and/or vocal tics persist for more than one year, and there is no tic-free period for more than 3 consecutive months.
Tourette’s Syndrome (TS)
Presence of multiple motor and one or more vocal tics for more than one year is defined as the absence of a tic-free period for more than 3 consecutive months. It is more common in boys (3-4/1) than girls. The average age of onset is 6-7.
At baseline, approximately 80% of patients have a motor tic and 20% a vocal tic. The most common initial tics are eye and other head and neck motor tics. Vocal tics usually appear one to two years after motor tics. Coprolalia (cursing speech), which can be seen as vocal tic in TS, begins at the age of 13-14. In TS, echolalia (imitation of sounds and words heard), echopraxia (imitation of the movements of others), copropraxia (involuntary, obscene gestures and signs), palillalia (imitation of the last syllable or word spoken by oneself) can also rarely be seen as complex vocal tics. .
Oppositional defiant disorder, conduct disorder, obsessive compulsive disorder and/or attention deficit hyperactivity disorder are seen with a frequency of 50-90% with TS. Special learning disability can be seen together in 15-25% of TS cases.
