Tics are sudden, rapid, repeated, non-rhythmic and recurring movements (motor tics or vocalisations (vocal tics). Tics are quite common in children and children may not always be aware of their presence.
Tics usually start in childhood around the age of seven, and are usually worst between 10-12 years. However, in approximately half of children, most tic symptoms disappear by the age of 18.
The first tics often start around the head and face, like blinking and/or grimacing. Vocal tics tend to appear later, around age 11.
Even within the same person, the tics may vary in many ways:
- they wax and wane; they get better and worse over time
- they change; one tic stops and another starts
- they may be made worse by stress and anxiety
- they may be alleviated with relaxation or concentration on an absorbing task
These changes are quite unpredictable. However, just before a tic is about to happen a child may experience so called premonitory sensations. These sensations can be either localised - in the area where the tic is about to happen - or generalised.
The presence of tics is sometimes associated with additional conditions (‘comorbidities’) which may include obsessive compulsive disorder (OCD) and/or attention deficit hyperactivity disorder (ADHD). Children and adults may also suffer from ‘rages’. Co-morbidities often present more problems than the tics and can be less visible.