Tics - Different types of tics

Tics are contractions of a group of muscles that either result in a movement (a motor tic) or a sound (a phonic or vocal tic).

Sometimes, tics may appear to be similar to normal movements. However, tics are not voluntary and most people are unable to control them.

The severity of a tic can change over time and sometimes a tic may stop and a different one starts.

Motor tics

Motor tics can be either simple or complex.

Simple motor tics

Simple motor tics only involve one muscle group. They include:

• blinking or twitching your eyes
• wrinkling your nose
• tongue movements, including sticking out your tongue
• twitching or jerking your head
• squatting and hopping
• snapping your fingers
• shrugging your shoulders

Complex motor tics

Complex motor tics either involve more than one muscle group or they're made up of a series of simple motor tics.

Complex motor tics are usually slower than simple motor tics and it can appear as if you're doing the movement intentionally. They can significantly interfere with your daily life but are rarely harmful.

Complex motor tics include:

• facial grimacing
• bending over to touch the floor
• smoothing your clothing
• biting your lip
• banging your head
• touching other people or things
• obscene gestures or movements

Vocal (phonic) tics

As with motor tics, vocal tics can also be simple or complex.

Simple vocal tics

Simple vocal tics involve making sounds by moving air through your nose or mouth. They include:

• coughing
• grunting
• barking
• hissing
• sniffing
• snorting
• clearing your throat

Complex vocal tics

Complex vocal tics involve saying words, phrases or sentences. They may include:

• repeating a sound, word or phrase
• using obscene, offensive or socially unacceptable words and phrases (although this is uncommon)

Complex vocal tics may interrupt your normal flow of speech, or they can sometimes occur at the beginning of a sentence in a similar way to a stutter or stammer.

When tics happen

Tics can start with a feeling of tension that builds up inside you (a premonitory urge). Some people also describe this as a hot, itchy or generally unpleasant sensation that you want to get rid of.

The sensation increases if you try to prevent the tic. After you've made the movement or sound, you may feel a sense of relief until the need to tic begins again.

Tics usually stop during sleep, although they can sometimes persist. They also tend to be less frequent when you're deeply absorbed in an activity.

Stress and anxiety can often make tics worse. They can also be worse when you are tired, excited or self-conscious about your tic being noticed.