Tics

Abstract

Tourette syndrome (TS) was originally described and conceptualized by Gilles de la Tourette in 1885. Since then, our understanding of tic disorders has grown immensely and continues to evolve at a rapid pace. Tics are abrupt, usually brief and repetitive, nonrhythmic movements (motor tics) and sounds (vocal tics). Motor tics can be further subdivided into simple and complex motor tics. Simple tics are sudden, meaningless movements most commonly involving eye blinking, facial grimacing, mouth gestures, and shoulder shrugs. Complex motor tics typically involve a series of stereotyped movements that may appear to be purposeful. Vocal (also called phonic) tics are similarly subdivided into simple and complex types. This review covers disease definition/subclassification, epidemiology, etiology/genetics, pathophysiology and pathogenesis, diagnosis, differential diagnosis, and treatment of tic disorders. Figures show a risperidone safety monitoring template for children, an aripiprazole safety monitoring template for children, and adult antipsychotic safety monitoring recommendations. The video shows how to perform the extrapyramidal symptom rating scale. Tables list classification of tic disorders, medication dosing suggestions, and TS deep brain stimulation guidelines. This review contains 3 highly rendered figures, 1 video, 3 tables, and 115 references.