Chronic motor or vocal tic disorder

Definition

Chronic motor or vocal tic disorder is a condition that involves quick, uncontrollable movements or vocal outbursts (but not both).

Alternative Names

Chronic vocal tic disorder; Tic - chronic motor tic disorder; Persistent (chronic) motor or vocal tic disorder; Chronic motor tic disorder

Causes

Chronic motor or vocal tic disorder is more common than Tourette syndrome. Chronic tics may be forms of Tourette syndrome. Tics usually start at age 5 or 6 and get worse until age 12. They often improve during adulthood.

Symptoms

A tic is a sudden, fast, repeated movement or sound that has no reason or goal. Tics can involve:

Excessive blinking
Grimaces of the face
Quick movements of the arms, legs, or other areas
Sounds (grunts, throat clearing, contractions of the abdomen or diaphragm)

Some people have many kinds of tics.

People with the condition can hold off these symptoms for a short time. But they feel relief when they carry out these movements. They often describe the tics as a response to an inner urge. Some say they have abnormal sensations in the area of the tic before it occurs.

Tics may continue during all stages of sleep, though may be less frequent. They may get worse with:

Excitement
Fatigue
Heat
Stress

Exams and Tests

Your health care provider can usually diagnose a tic during a physical examination. Tests are generally not needed.

People are diagnosed with the disorder when:

They have had the tics for more than a year
There is no other medical problem or substance use causing the symptoms

Treatment

Treatment depends on how severe the tics are and how the condition affects you. Medicines and talk therapy (cognitive behavioral therapy) are used when the tics greatly affect daily activities, such as school and job performance.

Medicines can help control or reduce tics. But they have side effects, such as movement and thinking problems.

Outlook (Prognosis)

Children who develop this disorder between ages 6 and 8 often do very well. Symptoms may last 4 to 6 years, and then stop in the early teens without treatment.

When the disorder begins in older children and continues into the 20s, it may become a lifelong condition.

Possible Complications

There are usually no complications.

When to Contact a Medical Professional

There is usually no need to see your provider for a tic unless it is severe or disrupts daily life.

If you cannot tell whether you or your child's movements are a tic or something more serious (such as a seizure), contact your provider.

References

Kim JW, Walter HJ, DeMaso DR. Motor disorders and habits. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 37.

Singer HS, Mink JW, Gilbert DL, Jankovic J. Tics and tourette syndrome. In: Singer HS, Mink JW, Gilbert DL, Jankovic J, eds. Movement Disorders in Childhood. 3rd ed. Philadelphia, PA: Elsevier; 2022:chap 7.

Tochen L, Singer HS. Tics and Tourette syndrome. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 98.