Stony Brook Center for Tics and Tourette's Disorder

What are Tics?
Tics are sudden, rapid, recurrent involuntary movements or sounds. Tics typically begin during childhood, often around the ages of four to six. Occasional or isolated tics are common among school-aged children, with about 15% of children experiencing tics at some point. Chronic tic disorders in which multiple tics are present for more than a year are less common and can cause significant distress and impairment in daily life.

What is Tourette’s Disorder?
Tourette's disorder is a type of tic disorder in which multiple motor tics and at least one vocal tic persist for at least 12 months. Motor tics often begin in the head and neck area, and can include eye blinking, nose movements, grimacing and shoulder shrugging. However, any part of the body can be involved, including the arms and the legs. Verbal tics can range from sniffing and throat-clearing to repeating syllables, words, or sentences.

People with chronic tic disorders, such as Tourette's disorder, may also have obsessive compulsive disorder (OCD) or OCD-like symptoms. These can include needing to touch objects in a particular way, or performing actions repeatedly until a sense of peace is obtained. Attention-deficit/hyperactivity disorder (ADD/ADHD) is also common in patients with tic disorders. Anxiety or mood symptoms, autism, and/or social or learning problems may also be present.

Treatment Approaches
Treatment varies from patient to patient. We provide a comprehensive evaluation in order to devise a developmentally appropriate treatment plan to address tics that interfere with one’s life. Depending on your condition, treatment may include: 

  • Medication 
  • Behavioral therapies 
  • Botulinum toxin injections 
  • Surgery for more severe cases 

Your tailored treatment plan may include:

  • Education about tics and Tourette's disorder
  • Management of neurological symptoms using medication
  • Comprehensive Behavioral Intervention for Tics (CBIT) (hyperlinked to CBIT webpage)
  • Management of co-occurring disorders such as:
    • Mild to moderate obsessive-compulsive disorder
    • Attention-deficit/ hyperactive disorder
    • Mood disorders
    • Anxiety
    • Depression
    • Behavioral concerns
    • Learning disorders
    • Management of cognitive and social issues 
    • Deep brain stimulation (DBS) surgery

MEET OUR TEAM

Neurology 
     (Adult)

  • Hanna Czarkowska, MD
  • Carine Maurer, MD, PhD
  • Guy Schwartz, M

     (Pediatric)

  • Lourdes Bello, MD
  • Tejwant Bindra, MD
  • Elizabeth Cruz, MD
  • Susan Mackey, NP
  • Louis Manganas, MD, PhD
  • Jill Miller-Horn, MD

Psychology

  • Dodie Gillett, PhD
  • Allison Nahmias, PhD
  • Jenna Palladino, PsyD
  • Angela Turner Dougherty, PhD

Psychiatry

  • Maged Soliman, MDChB

Neurosurgery

  • Charles Mikell, MD