Introduction of tics

By NHS Choices Last updated Apr 23, 2021 10

Tics are rapid, repetitive, involuntary contractions of a group of muscles.

They can occur as:

motor tics (bodily movements) – such as facial twitching, grimacing, blinking and shrugging the shoulders
phonic or vocal tics (sounds) – such as coughing, grunting, clearing the throat and sniffing

Most tics are mild and infrequent and they may not even be noticeable to the person experiencing them or to others. However, some tics can be frequent and severe.

When to see your GP

You should visit your GP if you or your child develops a tic and they:

occur regularly or become more frequent or severe
are associated with emotional problems or physical discomfort
are accompanied by other worrying moods or behaviours, such as anger, depression or self-harm

Your GP should be able to diagnose a tic from a description of the symptoms and by observing them. Special tests aren’t usually required. If possible, it can be helpful to record the movements on video so that you can show your GP.

What causes tics?

It’s not clear exactly what causes tics, although they are known to be related to the parts of the brain that control movement.

Tics often appear to run in families, so there may be a genetic reason why they develop. Tics can also be caused by certain types of medication or other health conditions, such as cerebral palsy.

There are things that can make tics worse, such as anxiety, stress, tiredness and excitement.

Most tics start during childhood. People who have them experience periods when they’re better and periods when they’re worse. This is often described as ‘waxing and waning’.

For many people, tics are only temporary. They tend to improve during the late teenage years or early adulthood.

Treating tics

If you have a mild tic, you may decide that treatment isn’t necessary. However, a number of different options are available.

Behavioural therapies are often recommended as a first choice treatment for tics. They include:

Habit reversal therapy (HRT), which aims to help you learn ‘responses’ (other movements) which ‘compete’ with tics, meaning that the tic cannot happen at the same time. HRT teaches you to use these competing responses when you get the feeling that you need to tic, until the feeling goes away.
Exposure with response prevention (ERP), which aims to help you get used to the overwhelming unpleasant feelings that are often experienced just before a tic.

There are also a number of medications that can improve tics in some people. In particularly severe adult cases, a new surgical treatment for tics called deep brain stimulation may be used.

Complications

Although tics often improve over time, they can cause some problems. In particular, you or your child may find it more difficult to make friends and you may experience bullying.

Studies have also shown that having a tic can affect your performance at school or work.

Read more about the complications of tics.