From the Guidelines
The most common tics include simple motor tics such as eye blinking, facial grimacing, head jerking, and shoulder shrugging, as well as simple vocal tics like throat clearing, sniffing, and grunting, with the average age of onset for tic disorders typically between 4 and 6 years old, as noted in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) 1.
Common Tics and Age of Onset
- Simple motor tics: eye blinking, facial grimacing, head jerking, and shoulder shrugging
- Simple vocal tics: throat clearing, sniffing, and grunting
- Average age of onset: 4 to 6 years old, with symptoms often peaking in severity around 10-12 years of age, as reported in a study published in Chest in 2015 1
Causes of Tics
- Abnormalities in brain circuits involving the basal ganglia, cortex, and thalamus, which regulate movement
- Genetic factors play a significant role, with tic disorders often running in families
- Environmental triggers can include stress, anxiety, excitement, fatigue, and certain medications
- Neurochemical imbalances, particularly involving dopamine, are implicated in tic disorders, as discussed in a guideline and expert panel report published in Chest in 2015 1
Diagnosis and Treatment
- The diagnosis of tic cough should be made when the patient manifests the core clinical features of tics, including suppressibility, distractibility, suggestibility, variability, and the presence of a premonitory sensation, as recommended in a guideline published in Chest in 2015 1
- Treatments include behavioral therapy, medications such as alpha-2 adrenergic agonists for mild to moderate tics, and antipsychotics for severe tics, though these carry more side effects, as noted in a study published in Chest in 2006 1
From the Research
Common Tics
- The most common tics are motor tics and vocal tics, although the specific types of tics are not detailed in the provided studies 2, 3, 4, 5, 6
Average Age of Onset
- The average age of onset for tics is not specified in the provided studies, which focus on the treatment and management of tics rather than their onset 2, 3, 4, 5, 6
Causes
- The causes of tics are not explicitly stated in the provided studies, which primarily examine the effectiveness of various treatments for tic disorders 2, 3, 4, 5, 6
Treatment and Management
- Comprehensive Behavioral Intervention for Tics (CBIT) is a effective treatment for tics, and can be administered individually or in groups 2, 3, 4, 5, 6
- CBIT combines habit reversal training and functional intervention to address the urge-tic relationship and tic-related environmental factors 3
- Other effective treatments for tics include Exposure and Response Prevention (ERP) and Habit Reversal Training (HRT) 4, 5