Repetitive throat clearing, blinking, and grimacing

Tourette’s disorder requires the presence of multiple motor tics and at least one vocal tic that have been present for at least one year. A tic is a sudden, rapid, recurrent, nonrhythmic motor movement or vocalization. Tics are often associated with a premonitory urge and may be temporarily suppressed. They typically begin between the age of four and six years, peak in severity in early adolescence, and then diminish. The majority of individuals spontaneously achieve remission by early adulthood. Because tic disorders commonly co-occur with psychiatric disorders, they should be screened for in every psychiatric interview. Treatment should begin with psychoeducation and focus on symptom reduction rather than remission. Behavioral interventions, including habit reversal therapy, may be considered. Medications, such as antipsychotics and alpha2 adrenergic agonists, should be considered if tics cause severe impairment and are moderate to severe.