TOURETTE SYNDROME AND TIC DISORDERS
ICD-10 Diagnostic Criteria
Syndromes in which the predominant manifestation is some form of tic. A tic is an involuntary, rapid, recurrent, non-rhythmic motor movement (usually involving circumscribed muscle groups) or vocal production that is of sudden onset and that serves no apparent purpose. Tics tend to be experienced as irresistible but usually they can be suppressed for varying periods of time, are exacerbated by stress, and disappear during sleep. Common simple motor tics include only eye-blinking, neck-jerking, shoulder- shrugging, and facial grimacing. Common simple vocal tics include throat-clearing, barking, sniffing, and hissing. Common complex tics include hitting oneself, jumping, and hopping. Common complex vocal tics include the repetition of particular words, and sometimes the use of socially unacceptable (often obscene) words (coprolalia), and the repetition of one's own sounds or words (palilalia).
Transient Tic Disorder F95.0 (307.21)
Meets the general criteria for a tic disorder but the tics do not persist longer than 12 months. The tics usually take the form of eye-blinking, facial grimacing, or head-jerking.
Chronic Motor or Vocal Tic Disorder F95.1 (307.22)
Meets the general criteria for a tic disorder, in which there are motor or vocal tics (but not both), that may be either single or multiple (but usually multiple), and last for more than a year.
Combined Vocal and Multiple Motor Tic Disorder [Gilles de la Tourette Disorder] F95.2 (307.23)
A form of tic disorder in which there are, or have been, multiple motor tics and one or more vocal tics, although these need not have occurred concurrently. The disorder usually worsens during adolescence and tends to persist into adult life. The vocal tics are often multiple with explosive repetitive vocalizations, throat-clearing, and grunting, and there may be the use of obscene words or phrases. Sometimes there is associated gestural echopraxia which may also be of an obscene nature (copropraxia).
F95.8 Other Tic Disorders
F95.9 Tic Disorder, Unspecified
Adapted with permission from International Statistical Classification of Diseases and Related Health Problems 10th Revision <http://apps.who.int/classifications/icd10/browse/2010/en>
In contrast to the DSM-5 nomenclature for tic disorders, the ICD-10 criteria do not require explicitly that an individual must have a past history of both vocal and motor tics occurring for at least 1 year to qualify for a diagnosis of Tourette syndrome (TS). However, the 1-year threshold is in place for the ICD-10 criteria specific for a chronic motor or vocal tic disorder. Likewise, an individual who has had tics for less than a year qualifies for a diagnosis of a "transient tic disorder," termed "provisional tic disorder" in DSM-5. Individuals whose tics have an age of onset after 18 or are exclusively present during the use of substances known to induce tics such as amphetamines, stimulants, and crack/cocaine qualify for the diagnosis of Tic Disorder Otherwise Specified. in DSM-5 and either Other Tic Disorder or Tic Disorder, Not Otherwise Specified (NOS) in ICD-10. In DSM-5, tic disorders, unlike ...