Tourette’s syndrome usually starts in childhood and is characterized by involuntary behaviors called tics and, in some patients, psychological problems such as obsessive compulsive disorder. Motor tics can vary from simple brief movements such as eye blinking, nose twitching or lip pursing to more complex behaviors such as repetitively tapping a doorknob prior to opening it. Vocal tics are also quite variable. Simple vocal tics include coughing, grunting and hissing and complex vocal tics such as repeating words or phrases can also occur. By definition tics are accompanied by a psychological urge to perform the behavior and a sense of relief after it occurs. Tics can be suppressed for short periods of time. A family history of tics is often present but not necessary for the diagnosis. When the symptoms are mild no specific treatment is necessary but in more severe cases there are several medications which can be used to help reduce the severity of symptoms.