Symptoms of Tourette's syndrome

If your child has tics, it doesn't necessarily mean they have Tourettes syndrome.

Children often develop  Orthodontics before growing out of them after several months. These are known as transient tics.

For tics to be classified as Tourettes syndrome, they have to be present for at least a year and include at least one vocal tic.

Tics can be:

• vocal (sounds)   such as grunting, coughing or shouting out words
• physical (movements)   such as jerking of the head or jumping up and down

Tics can also be:

• simple   for example, making a small movement or uttering a single sound
• complex  for example, making a series of movements or speaking a long phrase

Most people diagnosed with Tourettes syndrome have a combination of physical and vocal tics, which can be both simple and complex.

Simple vocal tics

Examples of simple vocal tics include:

• grunting
• clearing the throat
• coughing
• screaming
• sniffing
• squeaking
• blowing

Simple physical tics

Examples of simple physical tics include:

• blinking
• jerking the head
• twitching the nose
• teeth grinding  
• rolling the eyes
• twisting the neck
• rotating the shoulders

Complex vocal tics

Examples of complex vocal tics include:

• repeating other peoples phrases (echolalia)
• repeating the same phrase over and over again (palilalia)
• swearing loudly or shouting inappropriate words and phrases (coprolalia)

Swearing is often associated with Tourettes syndrome, but it's actually a fairly uncommon symptom affecting a minority of people with the syndrome.

Complex physical tics

Examples of complex physical tics include:

• shaking the head
• hitting or kicking objects
• jumping
• shaking
• touching themselves or others
• copying the movements of others (echopraxia)
• making obscene gestures, such as giving someone 'the finger' (copropraxia)

Premonitory sensations

Most people with Tourettes syndrome experience uncomfortable or unusual feelings before having a tic. These feelings are known as premonitory sensations.

Premonitory sensations are only relieved after the tic has been carried out, in a similar way to how an itch can only be relieved by scratching it.

Examples of premonitory sensations include:

• a burning feeling in the eyes that feels as if it can only be relieved by blinking
• tension in a muscle that can only be relieved by twitching or stretching the muscle
• a dry or sore throat that can only be relieved by grunting or by clearing the throat
• an itchy joint or limb that can only be relieved by twisting the joint or limb

Pattern of tics

If your child has Tourettes syndrome, their tics will probably tend to follow a set pattern. They may be worse during periods of:

• stress
• anxiety
• tiredness
• illness
• nervous excitement
• relaxation after a busy day 

On the other hand, the tics are often reduced when they're doing an enjoyable activity involving a high level of concentration, such as reading an interesting book or playing competitive sports.

You may find your child is able to control their tics when they're in situations where they would be particularly noticeable, such as in a school classroom. However, controlling tics can be difficult and tiring over prolonged periods of time.

Many children with Tourettes syndrome often experience a sudden 'release' of tics after trying to suppress them  for example, after returning home from school.

When to seek medical advice

You should contact your GP if either you or your child starts experiencing tics.

Many children have tics for several months before growing out of them, so a tic doesn't necessarily mean your child has Tourette's syndrome.

However, symptoms such as tics do need to be investigated.