Signs & Symptoms
The child or adolescent with Tourette's Disorder has involuntary motor and one or more vocal tics, which occur at some time during the illness but not necessarily together. The tics vary; they wax and wane and change over time in frequency and complexity. They may involve different parts of the body (face, neck, shoulders, trunk, hands). The most common simple motor tics are blinking, shrugging,grimacing and nose-twitching. Some complex motor tics may appear purposeful, such as kissing, pinching, sticking out the tongue, touching, gyrating, making obscene gestures (called copropaxia). Simple vocal tics are meaningless sounds and noises, including grunting, tongue-clicking, hooting, and throat-clearing.
Other Tic Disorders
Transient Tic Disorder, a more common tic disorder, generally appears during the early school years. This disorder affects from 5 to 24% of all children. It differs from Tourette's Disorder in that the tics occur daily for at least two weeks but for no longer than one year. However, the child may have a series of transient tics over the course of years. Tics can be voluntarily suppressed for brief periods, and most are mild and hardly noticeable. In some cases tics are frequent and severe and may affect many aspects of a child's life.
Chronic Motor/Vocal Tic Disorder, another category of Tic Disorder, appears before age 21. It usually persists unchanged throughout a period of more than 1 year and involves either motor or vocal tics, but not both.
Forty percent of children with TD have attentional problems, and 30 to 40% have academic difficulties which require intervention. The academic problems are generally secondary to attentional problems. Another possible problem area (for possibly as many as 80% of TD children) is preoccupation with obsessions and compulsions. Some (25 to 30%) may experience difficulties in controlling their aggression, which can lead to social problems.