Complex tics are distinct, coordinated patterns of successive movements involving several muscle groups. Complex tics might include jumping, smelling objects, touching the nose, touching other people, coprolalia, echolalia, or self-harming behaviors. People with TS can sometimes suppress their tics for a short time, but the effort is similar to that of holding back a sneeze. Eventually tension mounts to the point where the tic escapes. In most cases tics decrease markedly during sleep.
Neurotransmitters are chemicals in the brain that carry signals from one nerve cell to another.
Not all people with TS have disorders other than tics. The wide range of behavioral symptoms that can accompany tics may, in fact, be more disabling than the tics themselves. Patients, families, and physicians need to determine which set of symptoms is most disabling so that appropriate medications and therapies can be selected. Generally, TS is diagnosed by obtaining a description of the tics and evaluating family history. For a diagnosis of TS to be made, both motor and phonic tics must be present for at least 1 year.