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Motor tics can be of an endless variety and may include such movements as hand clapping, neck stretching, mouth movements, head, arm or leg jerks, and facial grimacing. A simple phonic tic can be almost any sound or noise, with common phonic tics being throat clearing, sniffing, or grunting. [10]
Common tics are blinking, coughing, throat clearing, sniffing, and facial movements. These are typically preceded by an unwanted urge or sensation in the affected muscles known as a premonitory urge, can sometimes be suppressed temporarily, and characteristically change in location, strength, and frequency.
Examples of the premonitory urge are the feeling of having something in one's throat, or a localized discomfort in the shoulders, leading to the need to clear one's throat or shrug the shoulders. The actual tic may be felt as relieving this tension or sensation, similar to scratching an itch.
Knowledge, education and understanding are uppermost in management plans for tic disorders, [6] and psychoeducation is the first step. [14] [15] A child's parents are typically the first to notice their tics; [16] they may feel worried, imagine that they are somehow responsible, or feel burdened by misinformation about Tourette's. [14]
Throat clearing may be articulated consciously or unconsciously, and may be a symptom of a number of laryngopharyngeal (upper respiratory tract) ailments. [1] Occasionally the cause is a common cold or post-nasal drip. The nose dispatches mucus which is meant to assist clearing infections and allergens.
PND may present itself through the constant presence of discomfort in the upper airways. It is classically described as the sensation of a substance "dripping down the throat" and may also present with rhinorrhea, constant throat clearing, and cough, although its symptoms can be very nonspecific. [ 2 ]
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Unlike tics, stereotypies usually begin before the age of three, involve more of the body, are more rhythmic and less random, and are associated more with engrossment in another activity rather than premonitory urges. Examples of early tics are things like blinking and throat clearing, while arm flapping is a more common stereotypy.