Tics and Tourette Syndrome (TS)

Diagnosis

No objective testing is available to confirm the diagnosis of tics; a careful history confirming classical tic characteristics should assist in making the diagnosis. If patients do not exhibit tics during an office examination, obtaining a video of the movements can provide essential diagnostic information.1-4

Tics usually do not impair the performance of activities of daily living. This is in contrast with other movement disorders, such as chorea, dystonia, tremor, psychogenic movement disorders, or obsessive compulsive behaviors. Stereotypies can be differentiated from tics by their onset before age three years, fixed and prolonged nature, and discontinuation with distraction.7 Vocal tics are uncommon in other neurological conditions.1

Children with sniffling, throat-clearing, and eye-blinking tics are frequently misdiagnosed with allergies or visual problems. Compulsions, manifestations of an OCD, may be mistakenly assumed to be tics.1