Education Hub ~ Tics

Tics and Tourette Syndrome

What is a Tic?

A tic is a sudden, rapid, repeating movement or sound that a person cannot control.

Motor Tics (Movement)

Examples:

Blinking or eye rolling

Facial movements or grimacing

Shoulder shrugging

Arm, leg, or head jerking

Touching or tapping objects

Vocal Tics (Sounds or Words)

Examples:

Throat clearing / coughing

Sniffing or clicking noises

Whistling

Words, phrases, or sounds (including animal sounds)

Mental (Cognitive) Tics

Some people experience thoughts that repeat on a loop.
These are just as real and can be just as challenging.

Premonitory Urges

Many describe a rising internal sensation before the tic happens.
Some find the urge more uncomfortable than the tic itself.

Why Tourette’s Is Often Misunderstood

For many years, media has focused mainly on coprolalia (swearing tics).
However, only around 10–15% of people with Tourette Syndrome experience this.

Most people with TS have:

Subtle tics

Internal sensations others cannot see

Fluctuations in symptoms depending on stress, tiredness, or environment

Because many tics can be small or easily masked, Tourette’s can often be invisible.

Even when tics are not obvious, individuals may still experience:

Muscle pain or fatigue

Throat soreness

Headaches

Embarrassment or anxiety

Low self-confidence or shame

This is why education matters — so that understanding can replace misunderstanding.

Here’s the truth:

No one has the right to question your diagnosis, your child’s diagnosis, or the way Tourette’s presents for you.

Tourette Syndrome exists on a spectrum, and no two people experience tics the same way.

Diagnosing Tourette Syndrome

Tourette Syndrome (TS) is a neurological condition that affects how the brain controls movement and sounds. For many people, Tourette’s is misunderstood because of how it has been portrayed in television, films, and social media. This can lead to confusion, assumptions, and unfortunately, people feeling that they need to prove their diagnosis.

How Tourette’s Is Diagnosed

A diagnosis is based on:

Having both motor and vocal tics

Present for more than 1 year

Starting in childhood

Tourette Syndrome is usually diagnosed by:

A Paediatrician

Neurologist

Child & Adolescent Mental Health Service (CAMHS)

Specialist in tic disorders

There is no scan or blood test for TS — diagnosis is clinical and based on symptoms.

Why Getting the Right Diagnosis Matters

Not all tics are Tourette’s. Tics can also appear due to:

- Anxiety and emotional stress

- Autism or ADHD

- Functional Neurological Disorder (FND)

- PANDAS/PANS (immune-related onset)

- Trauma

- Certain medications

Because these causes require different support, the correct diagnosis helps ensure:

- The right treatment

- The right strategies

- And reduced symptoms, rather than increased ones

Sometimes, a person may have both Tourette’s and another condition that affects tics, so it’s not about labels, but about getting the full picture.

Other
Tic
Disorders

Tourette Syndrome

Motor and vocal tics for more than 1 year.

Chronic (Persistent) Tic Disorder - Motor or vocal tics (only one type), lasting longer than 1 year.

Provisional (Transient) Tic Disorder

Tics lasting less than 1 year, usually in childhood.

Tics are often described as the tip of the iceberg because many individuals also experience features of other conditions, such as anxiety, sensory differences, ADHD, OCD traits, or emotional regulation challenges.

You Are
Not
Alone

Tourette Syndrome may look different from person to person, but every experience is real, and every experience matters.

If you would like support with:

Understanding diagnosis

Managing tics and urges

Reducing anxiety

Educating school, family, or workplace

Or supporting your child with confidence

I’m here to help.

Together, we move forward with knowledge, compassion, and empowerment.

Educating Your Circle

One of the most powerful forms of support is helping the people around you understand:

- What Tourette’s is

- How it affects you (or your child)

- What responses feel supportive

This doesn’t mean explaining yourself to everyone — but sharing with the people who matter most can reduce anxiety, build confidence, and create safer emotional space.

You do not need to pretend your tics do not exist.
You do not need to hide to make others comfortable.

Understanding grows when we are able to be seen.

Functional Tics

Having Functional Tics for longer than a year does not mean they “become” Tourette’s.

What are functional tics?

Functional Tics are part of a condition called Functional Neurological Disorder (FND).

FND affects how the brain sends and receives signals in the body.

There is no damage to the brain structure

The brain itself is healthy

But the communication system (the “mind-body software”) becomes overwhelmed or stuck in a loop.

A useful way to understand this is:

If the brain is the computer:

The hardware is healthy

But the software program is glitching or overloaded

This means the symptoms are very real, even though they are not caused by a traditional neurological condition.

Functional Tics vs Tourette

Functional Tics can look very similar to tics seen in conditions such as Tourette Syndrome but the cause is different.

It is also possible for someone to have both genetic tics and Functional Tics, which is very common and does not mean anything is “wrong” with you. It simply means your brain and nervous system are responding to something in a different way.

Functional Tics often begin in:

Teenage years or young adulthood

And are more common in girls and people assigned female at birth

However, anyone can develop them at any age.

What Functional Tics Can Look Like

Functional Tics can involve:

Large or dramatic movements
Sudden full-body jerks
Repetitive postures or gestures
Complex, longer, or “performative” movements
Loud vocalisations or repeated phrases

They often:

Begin suddenly
Develop quickly into more complex patterns
Are more noticeable in stressful, stimulating, or social environments
May reduce when a person feels safe, calm, or focused on something absorbing

Other Symptoms That May Occur Alongside Functional Tics

Not everyone experiences these but some people may also have:

Fatigue or lack of energy
Chronic pain or headaches
Anxiety or panic
Mood changes or emotional overwhelm
Dissociation or “checking out”
IBS or stomach discomfort
Functional seizures (non-epileptic seizures)
Limb weakness or numbness
Sensory overload

Again, these symptoms are real.

They are not deliberate, attention-seeking, or behavioural.

Why Do Functional Tics Happen?

There is no single cause, but common contributing factors include:

Stress overload or emotional pressure

Significant life change or disruption

Trauma (recent or past)

Anxiety or chronic worry

Burnout or exhaustion

Masking neurodivergence (e.g., ADHD or Autism)

Sensory overwhelm

Identity or social pressures

Learned physical patterns reinforced by the brain

Functional Tics are the body’s way of sounding an alarm when the nervous system is overloaded.

The tic is not the problem.
The tic is the signal that something deeper needs space and support.

Diagnosis

Diagnosis is usually made by:

Neurology

Paediatric specialists

Psychologists or therapists experienced in FND

Sometimes a multidisciplinary team

A helpful assessment looks at:

Symptom history

Suddenness of onset

Patterns of stress and nervous system overload

Family and developmental timeline

Differentiation from genetic tic disorders like Tourette’s

How Functional Tics Differ from Tourette’s

PANS/ PANDAS

What Is PANDAS?

PANDAS stands for:

Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections.

This condition occurs when the body responds to a Group A Strep (GAS) infection (such as strep throat, scarlet fever, or sometimes impetigo).

In some children, the immune response mistakenly affects an area of the brain involved in movement, behaviour, and emotional regulation (the basal ganglia).

Typical Characteristics

Sudden and dramatic onset (often literally overnight)

Symptoms may appear after: Strep throat Tonsillitis Scarlet fever Skin infections caused by strep

Common Symptoms

New or suddenly worsening tics
Obsessive-compulsive behaviours or intrusive thoughts
Eating changes (including fear of swallowing or loss of appetite)
Sleep difficulties
Behavioural regression (acting younger than their age)
Sudden anxiety, clinginess, or separation fears
Irritability or emotional outbursts
Handwriting deterioration or decline in school performance
Increased urination or urinary accidents

Child may appear overwhelmed, “frozen,” or emotionally “stuck”

Children often describe feeling trapped inside their own body, which can be very distressing.

What Is PANS?

PANS stands for:

Paediatric Acute-onset Neuropsychiatric Syndrome.

PANS has a similar rapid onset, but it is not limited to strep.

It can be triggered by:

Other infections (viral, bacterial, sinus infections)

Inflammation

Autoimmune response

Environmental stress

Metabolic factors

Key Features

A child may be diagnosed with PANS when:

There is a sudden onset of OCD or severe eating restriction

AND

At least two of the following symptoms also appear:

Anxiety - Especially separation anxiety
Mood changes - Emotional swings, sadness, depression
Irritability or aggression - Arguments, meltdowns, frustration
School decline - Memory issues, loss of skills, difficulty focusing
Motor or sensory changes - Tics, sensory overload, handwriting changes
Sleep difficulties - Insomnia or very disrupted sleep
Urination changes - Bedwetting or frequent urination

If strep is the trigger, a child may meet criteria for both PANS and PANDAS.

Diagnosis

Diagnosis is usually made by:

Paediatrics

Neurology

Immunology or Rheumatology

Specialist services familiar with PANS/PANDAS

There is no single test, so clinicians look at:

Medical history

Infection history

Physical exam

Behavioural and emotional changes

Blood tests (sometimes) to look for inflammation or recent infection

The most important feature is the sudden change.

Treatment and Support

Treatment often includes a combination of:

Medical management (to treat underlying infection or inflammation)

Therapy and emotional support to manage anxiety, OCD, or behaviour changes

School support strategies

Gentle family guidance for stress reduction and coping

With the right support, many children experience significant improvement.