Motor and Vocal Tics

Tics are spasm-like contractions of muscles most commonly involving the face, mouth, eyes, head, neck or shoulder muscles. Tic movements often appear to be intentional but in fact are not under the control of the person making them. There are two kinds of tics, motor and vocal.

Motor tics can be simple or complex. Simple motor tics involve only one muscle group. They can be embarrassing or painful (such as jaw snapping). Simple motor tics include:

• Quick eye blinks or eye jerks
• Tongue movements, including sticking out the tongue
• Head twitches or head jerks
• Squatting and hopping
• Shoulder shrugs

Complex motor tics can be a combination of many simple motor tics or a series of movements that involve more than one muscle group. Complex motor tics are slower and often appear as if the person is doing the movement intentionally. These type of tics can interfere greatly with daily life and may be harmful (such as head banging or lip-biting). They include:

• Facial grimacing
• Touching people or things
• Obscene gesturing or gyrating movements

Vocal tics can be simple or complex. Simple vocal tics involve sounds made by moving air through the nose or mouth, including grunting, barking, hissing, sniffing, snorting or throat clearing.

Complex vocal tics may involve words, phrases and sentences. Patients with a complex motor tic may repeat their own words (palilalia) or other people's words (echolalia) and may use obscene words (coprolalia). These vocal tics may interrupt the flow of a normal conversation or occur at the beginning of a sentence, much like a stutter or a stammer.

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