Tourette Syndrome - Symptoms

Patients with TS can exhibit a range of symptoms. Most patients will have some but not all of the symptoms. Motor tics and obsessive thoughts are the most common symptoms. Compulsive behavior is also common among TS patients. A compulsive behavior is an action performed over and over again for no apparent reason. Constant hand washing is an example of compulsive behavior.

Patients with TS may have other mental disorders. For example, they may have trouble controlling their impulses, or they may talk in their sleep or awaken frequently. Many TS patients also have the learning disorder known as dyslexia (see dyslexia entry).

The tics associated with TS can be simple or complex. A simple tic involves a sudden, brief movement of a single group of muscles. It is generally repeated several times. A complex tic consists of a repeated pattern of movements that can involve several muscle groups, usually in the same order. An example of a complex tic might be a side-to-side head movement followed by eye blinking followed by opening the mouth then stretching the neck.

Vocal tics can consist of sounds and noises that have no meaning. Or they can involve the use of words and phrases repeated over and over again. Tics tend to get better and worse in cycles. Patients often develop new tics as they grow older. The symptoms of TS may get better for weeks or months, only to become worse later.

Some examples of tics associated with TS include the following:

• Simple motor tics: Blinking the eyes, pouting the lips, shaking or jerking the head, shrugging the shoulders, grimacing (making faces), sudden kicking movements, snapping the jaws, and clicking the teeth.
• Complex motor tics: Jumping up and down, touching parts of the body or certain objects, smelling things over and over again, stamping the feet, twirling about, throwing or arranging objects, head-banging, writing the same letter repeatedly, and making obscene gestures.
• Simple vocal tics: Clearing the throat, coughing, snorting, barking, grunting, clicking the tongue, whistling, hissing, and making sucking sounds.
• Complex vocal tics: Repeating phrases such as "Oh boy," "all right," or "what's that?"; saying dirty words or offensive racial expressions; speaking very rapidly or loudly, and repeating whole sentences over and over.