Tics are involuntary movements or vocalizations. The term goes back to the French word tic, which means "nervous twitching". Tics with abrupt movements are called motor tics. Tics in combination with vocalizations are called vocal tics. The combination of vocal and motor tics is Tourette's syndrome. There is a further differentiation according to the type of expression: Simple and complex tics.
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Motor tics lead to sudden movements. These have no purpose, do not pursue a goal and can be very violent.
While simple motor tics only affect one muscle group, complex motor tics can involve several muscle groups. They can give the impression that the person affected is fulfilling a purpose.
Complex motor tics can cause sufferers to stamp their feet unexpectedly, hop or jump up from a chair. The special forms of complex motor tics include copropraxia and echopraxia.
Copropraxia involves obscene movements. Gestures such as pointing the middle finger, sticking out the tongue or touching one's own genitals are typical symptoms.
Echopraxia refers to the involuntary imitation of other people's gestures and movements.
Vocal tics, on the other hand, are involuntary vocalizations such as throat clearing, smacking and grunting. The special forms of complex vocal tics include echolalia, coprolalia and palilalia.
Echolalia is characterized by the constant repeating of what is heard. Those affected mimic words, sentences or sounds over and over again. Echolalia often occurs in conjunction with schizophrenia and autism.
Palilalia is similar to echolalia. Those affected repeat spoken words over and over again and increase their speaking speed in the process. Palilalia is a typical accompanying symptom in people with tic disorders. It also occurs in conjunction with Parkinson's disease.
A characteristic of coprolalia is the compulsive use of vulgar terms. It is a common side effect of tic disorders. Those affected cannot influence their behavior.
Compulsive symptoms or AD(H)S often occur alongside the tics© Creative Cat Studio | AdobeStock
The causes of primary tics, which occur for no apparent reason, have not yet been clarified. Based on the observation of familial clusters, genetic causes are assumed.
Secondary tics are signs of another underlying disease. They occur, for example, in connection with the following diseases:
In most cases, tic disorders occur for the first time in childhood. The affected child is initially unaware of the disorder.
Doctors assume that almost every second child of primary school age develops a tic. The majority of those affected are boys. The reason for the different distribution is not yet known.
Tics are often only a temporary phenomenon. The symptoms usually become less severe with increasing age.
The diagnosis of a tic disorder or Tourette's syndrome is made in several steps.
To rule out a connection between the tics and other illnesses, e.g. epilepsy, doctors first carry out an EEG (electroencephalogram).
This is followed by an examination of liver, thyroid and kidney values, as functional disorders of various organs can also cause tics.
The neurologist examines the familial disposition in order to identify a genetic predisposition.
Major changes (divorce of parents, death of a family member) can trigger severe crises and tics in children and adolescents. These tics are often temporary. The prerequisite is that the therapy for the underlying illness is successful.
Special questionnaires for parents and relatives make it easier to diagnose and assess the severity. Respondents must record their observations over several weeks.
The therapy for tic disorders consists of
For mild forms of the disorder, support from teachers and parents can already help. It is recommended to pay as little attention as possible to the tic. This reduces the impact of the disorder on the life of the person affected. Medication and therapy are not necessary for mild symptoms.
With severe symptoms, a strong will alone is not enough. The person affected is severely impaired and needs the help of a psychotherapist.
Cognitive behavioral therapy achieves good results. Habit reversal training has proven its worth.
Learning relaxation methods such as autogenic training or progressive muscle relaxation can bring about a significant reduction in symptoms.
Long-lasting tic disorders can severely impair quality of life. In children and adolescents, severe tics or Tourette's syndrome often lead to depression and suicidal thoughts.
If psychotherapeutic support is not sufficient, medication is required. Children should only be given the lowest dose that causes a reduction in symptoms.
Possible medications are
Surgery only provides relief in exceptional cases.
Mild tic disorders are temporary in most cases. The disease peaks at the age of 12. After that, the symptoms usually become less severe.
15 to 20 percent of people with Tourette's syndrome suffer from coprolalia. This severe form of vocal and motor tics leads to significant limitations for the patient. At school, at work and in private life. Long-term psychological support is required. A cure for Tourette's syndrome is not yet possible.
Patients with tic disorders need special attention. Positive examples show that inclusion and participation in social life is possible. This requires comprehensive information and good cooperation between parents, doctors, therapists and teachers.
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