Tics, tic syndrome, tic disorder, Tourette’s syndromeTics are simple or complex, sudden, short-lived, involuntary or semi-autonomous movements (motor tic) or sounds (vocal tic). With an internally growing tension they can be suppressed for a short time. Patients perceive the tics as an inner compulsion and often feel discomfort in the corresponding body region, which is then the reason for carrying out the movement.
The figures on the frequency of a tic or tics in the general population vary greatly. In a study of 7-year-olds in the UK, the frequency of tics was found to be 4% with equal gender distribution. However, in a study of Parisian schools, the frequency was only 0.87%.
This difference is due to the different methods of data collection. For example, in one study, patients with less severe symptoms are included in the figures, whereas in another study they are not. In general, however, it can probably be said that temporary tics in childhood-youthful age occur worldwide in the population with a frequency of about 4.8%, whereby boys are affected more often and more severely than girls.
The gender ratio is about 3:1 and in Germany it is about 6.6% of the total population. In connection with Tourette’s syndrome, whose symptoms are both vocal and motor tics, tics were first mentioned in medical literature in 1825 by Jean Itard, a French doctor and pedagogue (1774-1838). He described the conspicuous behavior of the Marquise de Dampierre, who had complex vocal tics since she was 7 years old.
Sixty years later, the French neurologist George Gilles de la Tourette published a study on the Marquise de Dampierre and eight other patients who suffered from similar tics. The study was published under the title: “Étude sur une affection nerveuse caracterisée par l’incoordination motrice accompagnée d’écholalie et de coprolalie de la Neurologie, paris 9, 1885, 19-42 et 158-200” Dr. Tourette described the disease, now known as Tourette’s syndrome, as the “Maledie des Tics. “There are different ways of classifying it: motor and vocal tics are distinguished: chronic and transient (transitory) tics are distinguished: simple tics are distinguished from complex tics:
- Motor tics are movements of the body.
- Vocal tics are noises, sounds or speech.
- Transitory tics are very common during childhood.
These are single or multiple tics, which usually involve winking, grimacing or shaking your head. The tics begin before the age of 18 and last up to twelve months.
- Chronic tic disorders can be motor or vocal in nature, but only one of the two. It can be one or more motor or vocal tics.
The duration is longer than one year.
- If motor and vocal tics occur in combination, this is called Tourette’s syndrome.
- Simple motor tics: movements restricted to one muscle region Simple vocal tics: only sounds, no words
- Complex motor tics: coordinated movements of several muscle regions
- Complex vocal tics: words or sentences
The cause of the tics is not clear. However, one assumes functional disorders in the area of the brain systems that have the messenger substance (transmitter) dopamine, as is the case for example in the basal ganglia. Transmitters are substances that serve to transmit signals in the brain and are excessively active when tics occur.
The thesis is supported by the fact that opponents of dopamine (dopamine antagonists) reduce the tics, whereas substances that imitate the action of dopamine (dopamimetics) and thus increase the dopamine effect, as well as substances such as amphetamines, trigger tics. Furthermore, the number of docking sites (receptors) for dopamine (D2-receptor) corresponds to the degree of severity of the disease. Likewise, disorders in the systems in which serotonin is present as a messenger substance are also assumed to be the cause.
It is also assumed that tics is a hereditary disease. In 60% of patients, tics can be detected in family members, i.e. there is a so-called “positive family history”. The hereditary process is probably dominant or even semi-dominant, i.e. only one parent must have the diseased gene for their child to also suffer from tics.However, the disease does not have to be inherited in the same degree of severity, but can also include only slight tics.
In general, it can be said that women are affected less often and less severely than men. Tics have also been observed when women stop taking so-called nerve suppressants (neuroleptics) and drugs for epilepsy (antiepileptic drugs). Winking of the eyes, rolling of the eyes, facial grimaces, sniffing of the nose, pouting of the lips, pulling up the shoulders, shaking of the head, slinging the arms, pulling in the abdomen, pulling out the abdomen, finger movements, opening the mouth, chattering of the teeth, body tension, rapid flinging movements of different parts of the body, raising the eyebrows, frowning, hopping, clapping, touching objects/persons or oneself, smoothing out fabric folds, running through the hair, throwing movements, biting one’s tongue or lips or in the arm, hitting one’s head, bouncing movements, pinching or scratching oneself, pushing movements, writing movements, curving twitches, sticking out the tongue, kissing, writing the same letter or word over and over again, pulling back the pen while writing, tearing paper or books, repeating just seen coordinated movements (echopraxy), indecent movements such as masturbation movements (copraxia) Groaning, moaning, blowing, whistling, coughing, sniffing, smacking, barking, grunting, gurgling, clearing your throat, burping, screeching, flicking, etc.
u, eee, au, oh and other sounds repeated ejection of obscene and aggressive expressions (coprolalia), repetition of sounds or words that have just been heard (echolalia), repetition of syllables (palilalia), speech disorders, unusual speech rhythms, rituals such as repeating a sentence until it is “just right”. The coprolalia can be further subdivided into: The tics can be suppressed for some time. The occurrence of tics in some patients is associated with a sensation such as itching, tingling or burning.
These sensations are called sensory tics. The execution of the tic should lead to a reduction of the sensation, for example by blinking or clearing the throat. All tics are often aggravated by stress and become weaker with concentration.
During sleep they stop, but falling asleep and sleep itself are often disturbed (see Sleep disorders). Relaxation before falling asleep often triggers the tics. Rarely can aggressive tics develop that are directed against oneself or others.
For example, patients may injure their eyes with a writing instrument or put cigarettes on their skin. Injuring another person is extremely rare, however.
- Sexual and bodily curses: “Scheixxe, Fixxxn, Basxxxd, Arsxxxxxh
- Theological Curses: “God Damned, Heaven
- Racist and ethnic insults: “cripples
- Complex and aggressive sexual descriptions: “You fat bastard of a witch “
- Complex contradictory statements: “I like them, I hate them.
Clearing the throat is one of the simple vocal tics.
It is one of the tics that occurs most frequently in children. Sometimes the clearing tic occurs after an infection and remains for a while, even after the infection has healed. A kind of “memory clearing” can occur by lowering the clearing threshold.
This means that the affected person clears his throat involuntarily, so to speak from memory. This clearing tic can be very disturbing for the environment. These reactions then put the affected person in a stressful situation, which even intensifies the tic.
As a rule, the clearing tic is harmless if there are no other complaints and disappears again spontaneously. Tics, in the form of facial twitches, can have various causes. These twitches can only be controlled arbitrarily to a limited extent.
A distinction is made between twitches that occur without an external stimulus and those that occur as a result of a reflex stimulus. The twitches, without external stimulus, can result from tiredness or stress. If there are no further complaints, these twitches are harmless and often disappear as spontaneously as they came.
The facial twitches that occur due to a tap on the cheek are the result of an increased excitability of the muscles and nerves. Consequently, the entire mimic musculature usually twitches. This is also called tetany.
If there is only a slight twitching at the corner of the mouth, this indicates a vegetative cause rather than tetany.Irrespective of its severity, this reflex cannot usually be triggered in a healthy person and gives indications of a possible disease. The facial twitching caused by a tap on the cheek results from an increased excitability of the muscles and nerves. Consequently, the entire mimic musculature usually twitches.
This is also called tetany. If there is only a slight twitching at the corner of the mouth, this indicates a vegetative cause rather than tetany. Irrespective of its severity, this reflex cannot usually be triggered in a healthy person and gives an indication of a possible disease.
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