"My neck cranes to the right, then the muscles of the left side of my face and neck contract, squinting my left eye and tilting my head briefly forward. My left arm arises until my hand halts directly in front of my face. I am frozen for a moment; I emit a tiny — almost inaudible — whoop. And then I go back to my writing for half a minute or so until a whole collection repeats itself. ... I am in a university library, surrounded by strangers, and so I painstakingly sublimate these tics, disguising them as stretches, glances around the room, and throat clearing." – P.J. Hollenbeck, 2003
The symptoms were first described more than a hundred years ago by the French neurologist Gilles de la Tourette, and his name has been given to the disorder now regarded as the most common cause of tics — brief intermittent involuntary or semi-voluntary movements or sounds. According to the American Psychiatric Association, a diagnosis of Tourette's disorder requires many motor tics (movements) and at least one vocal or phonic tic (sound), with symptoms beginning before age 18 and lasting more than a year.
Often the earliest signs are rapid blinking and twitching of the mouth and nose. Other motor tics are head jerking, tooth grinding, neck twisting, abnormal postures and muscle contractions. More complex movement tics include facial contortions, squatting, deep knee bends, bowing, jumping, obscene gestures and imitation of other people's gestures.