Introduction

This chapter describes aspects of tics and tremors including clinical features, oral medication treatment and the utility of botulinum neurotoxin (BoNT) injections as a therapeutic modality.

Tics

Tics are brief, sudden, movements (motor tics) or sounds (phonic tics) that are intermittent but may be repetitive and stereotypic (Jankovic and Kurlan, 2011). When motor tics and phonic tics coexist without other neurological abnormalities, the diagnosis of Tourette’s syndrome should be considered. Most patients with Tourette’s syndrome have also a variety of comorbid disorders such as attention deficit disorder, obsessive compulsive disorder and impulse control disorders. Tourette’s syndrome is considered a genetic neurodevelopmental disorder but its pathogenesis is not well understood (Jankovic and Kurlan, 2011). Although Tourette’s syndrome is the most common cause of childhood-onset tics, there are many other causes of tics, including autistic disorder and various insults to the brain and basal ganglia (infection, stroke, head trauma, drugs and neurodegenerative disorders).