A myriad of symptoms can be attributed to Tourette syndrome. However, some of the most well known, like bursts of obscenities, are the rarest symptoms. The most common symptoms are usually normal activities, like eye-blinking, performed in repetition. Some common symptoms may be so slight that many observers would not notice them at al
A tic is a sudden, spasmodic, involuntary muscular contraction that usually occurs in midline body regions like the face, neck, pharynx, shoulders and torso. These tics can be classified by type (motor or vocal) and severity (simple or complex). A motor tic involves involuntary movements, and a vocal tic involves involuntary utterances. A simple tic is a sudden, spasmodic, involuntary contraction of only a small number of muscle groups. A common example of a simple motor tic is eye-blinking, and a simple vocal tic could be throat-clearing. A complex tic involves distinct and coordinated patterns of many different muscle groups. A common example is eye-blinking coupled with shoulder shrugs and facial grimaces. A complex vocal tic involves spontaneous expression of words or phrases.
The location of a patient's tics can change, but they usually begin in the face and neck. The most common initial tics are eye-blinking and facial movements. Over time, tics tend to spread in a downward progression. From the face and neck, tics could progress to the arms and hands, with patients shrugging their shoulders or clenching their fists. They can then move on through the body and lower extremities, possibly causing patients to stomp their feet or walk peculiarly. Finally, the tics can progress to the respiratory and alimentary(digestive) system, where they can include hiccuping, whistling, belching and throat-clearing.
The tics can change in frequency, location and severity and are usually preceded by an urge. Patients describe this urge as a rising tension that is released by the tic. Patients can suppress their tics for a short time period, which usually results in a more severe tic later. Tourette's tics can increase in times of emotional stress or if the patient sees someone perform their involuntary action. For example, a patient who suffers from a motor tic like repetitive sniffing may be triggered by hearing someone else sniff. Tics can decrease in times of intense focus or during sleep.