The signs of Tourette Syndrome(TS) can be quite easy to notice since the tics will cause the individual to make unusaual movements or sounds. Most people with Tourette syndrome first notice symptoms during childhood, between ages 7 and 10. TS always happen a before the age of 18-21 TS usually begins with mild, simple tics involving the face, head, or arms and with time the tics can become more frequent and increase in variety, involving more body parts such as the trunk or legs. They often become more disruptive to activities of daily living. Usually appearing in childhood, their severity varies over time. In most cases, tics become milder and less frequent in late adolescence and adulthood.
There are two types of tics present in TS,motor tics and vocal tics. Those than can be subdivided into simple and complex tics. Simple motor tics are normally sudden and rapid movements known as clonic tics but they can also involve longer more sustained movements known as tonic tics. A 3rd type of tic called a dystonic tic and is similar to the actions of dystonia.Simple phonic tics involve single simple sounds,animal noises,grunts and ect. Both simple motor and phonic tics can change into complex motor and phonic tics. A complex motor tic would be actions such as hopping,squatting,repetitive touching of others, deep knee bending, jumping, smelling of objects, hand gesturing, head shaking, or leg kicking. Complex vocal tics involve palilalia (repeating certain phrases or words out of context), echolalia (repeating the last words or phrases spoken by others) or coprolalia (explosive cursing or compulsive utterance of obscene words or phrases).
Tics are classified as either simple or complex.
Simple tics
Simple motor tics are sudden, brief, repetitive movements that involve a limited number of muscle groups. Some of the more common simple tics include eye blinking and other vision irregularities, facial grimacing, shoulder shrugging, and head or shoulder jerking. Simple vocalizations might include repetitive throat-clearing, sniffing, or grunting sounds.
Complex tics
Complex tics are distinct, coordinated patterns of movements involving several muscle groups. Complex motor tics might include facial grimacing combined with a head twist and a shoulder shrug. Other complex motor tics may actually appear purposeful, including sniffing or touching objects, hopping, jumping, bending, or twisting. Simple vocal tics may include throat-clearing, sniffing/snorting, grunting, or barking. More complex vocal tics include words or phrases. Perhaps the most dramatic and disabling tics include motor movements that result in self-harm such as punching oneself in the face or vocal tics including coprolalia (uttering swear words) or echolalia (repeating the words or phrases of others). Some tics are preceded by an urge or sensation in the affected muscle group, commonly called a premonitory urge.
Some with Tourette syndrome will describe a need to complete a tic in a certain way or a certain number of times in order to relieve the urge or decrease the sensation. Tics are often worse with excitement or anxiety and better during calm, focused activities. Certain physical experiences can trigger or worsen tics, for example tight collars may trigger neck tics, or hearing another person sniff or throat-clear may trigger similar sounds.
Tics may occur many times a day, but they tend to improve or get worse at different times. The tics may change with time. Symptoms usually get worse before the mid-teen years. Many people with Tourette syndrome can stop doing the tic for periods of time. However, they find that the tic is stronger for a few minutes after they allow it to start again. Often the tic slows or stops during sleep.
http://health.nytimes.com/health/guides/disease/gilles-de-la-tourette-syndrome/overview.html
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