Simple tics are sudden, brief, and involve small muscle groups, while complex tics are distinct, coordinated, and have patterns that involve large muscle groups (National Institute of Neurological Disorders and Stroke, 2012). A simple tic may be an eye blink, and a complex tic may be a shoulder shrug. Vocal tics may or may not occur with the movement tics and can include grunting, throat clearing, and shouting (Walkup, 2007). Vocal tics can also be singular and appear by themselves. Although the symptoms of TS vary and range from very simple to complex, most cases fall into the simple or mild category. More than 80% of patients have significant improvement of tics by adulthood but, about one-third of patients with TS have co-occurring conditions including obsessive-compulsive disorder, and one-half have attention deficit/hyperactivity disorder that continue throughout their lifetime (Abi-Jaoude & Gorman, 2013). Tics can be worse with excitement or anxiety and may be better during calm and focused situations. According to the National Institute of Neurological Disorders and Stroke, “certain physical experiences can trigger or worsen tics” (National Institute of Neurological Disorders and Stroke, 2012, para. 4). Tics do not go away during sleep, but usually relax (National Institute of Neurological Disorders
Simple tics are sudden, brief, and involve small muscle groups, while complex tics are distinct, coordinated, and have patterns that involve large muscle groups (National Institute of Neurological Disorders and Stroke, 2012). A simple tic may be an eye blink, and a complex tic may be a shoulder shrug. Vocal tics may or may not occur with the movement tics and can include grunting, throat clearing, and shouting (Walkup, 2007). Vocal tics can also be singular and appear by themselves. Although the symptoms of TS vary and range from very simple to complex, most cases fall into the simple or mild category. More than 80% of patients have significant improvement of tics by adulthood but, about one-third of patients with TS have co-occurring conditions including obsessive-compulsive disorder, and one-half have attention deficit/hyperactivity disorder that continue throughout their lifetime (Abi-Jaoude & Gorman, 2013). Tics can be worse with excitement or anxiety and may be better during calm and focused situations. According to the National Institute of Neurological Disorders and Stroke, “certain physical experiences can trigger or worsen tics” (National Institute of Neurological Disorders and Stroke, 2012, para. 4). Tics do not go away during sleep, but usually relax (National Institute of Neurological Disorders