Primary adult-onset tics

A titillating title (at least for doctors and tic researchers)

Adult-onset tics are rare, and usually secondary (i.e. due to some other neurological insult). However, there must be exceptions, and they are of interest both to patients and for understanding what factors cause tics and modify their course. I am aware of at least one study with relevant information. A multicenter German family study of Tourette syndrome and OCD found that 5 relatives were convinced that tics started between ages 21 and 25 (Hebebrand 1997). Their symptoms and course were in other ways typical of TS. Of course some could have had childhood tics that were not noticed at the time, but alternatively, there is no strong reason to expect that a tic disorder starting at age 22 is so very different from a tic disorder starting at age 17.

Today the journal Tremor and Other Hyperkinetic Movements shows on its main page, under "in press," this new article: "How much do we know about adult-onset primary tics? Prevalence, epidemiology, and clinical features," by Yale's Daphne Robakis. Their group previously reported the more common occurrence of tic exacerbation during adulthood (Schaefer 2017). The new article is not yet live, but I am eager to read it when it is published. Tremor claims an average time from acceptance to publication of about 3 weeks, so hopefully the wait will be short.

Now online.

Citation: (Robakis 2017)


  1. J Hebebrand, B Klug, R Fimmers, SA Seuchter, R Wettke-Schäfer, F Deget, A Camps, S Lisch, K Hebebrand, Gontard A von, G Lehmkuhl, F Poustka, M Schmidt, MP Baur, H Remschmidt. Rates for tic disorders and obsessive compulsive symptomatology in families of children and adolescents with Gilles de la Tourette syndrome. J Psychiatr Res 31, 519–530 (1997). Link

  2. D Robakis. How Much Do We Know about Adult-onset Primary Tics? Prevalence, Epidemiology, and Clinical Features. Tremor Other Hyperkinet Mov (N Y) 7, 441 (2017). Link

  3. SM Schaefer, CA Chow, ED Louis, D Robakis. Tic Exacerbation in Adults with Tourette Syndrome: A Case Series. Tremor Other Hyperkinet Mov (N Y) 7, 450 (2017). Link

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