A premonitory urge is a sensory phenomenon associated with

Tourette syndrome Tourette syndrome (TS), or simply Tourette's, is a common neurodevelopmental disorder that begins in childhood or adolescence. It is characterized by multiple movement (motor) tics and at least one vocal (phonic) tic. Common tics are blinkin ...

and other tic disorders. Premonitory urges are "uncomfortable feelings or sensations preceding tics that usually are relieved by particularmovement". "Individuals with tics may have either a generalized or a localized sensation of tension that is relieved by movement, hat isthe tic." Sensory phenomena in tic disorders include bodily sensations, mental urges, and a sense of inner tension, feelings of incompleteness, and a need for things to be "just right". Bodily sensations include focal or generalized body sensations (usually tactile, muscular-skeletal/visceral, or both); mental sensations include urge only, energy release (mental energy that builds up and needs to be discharged), incompleteness, and just-right perceptions. Published descriptions of the tics of Tourette's identify sensory phenomena as the core

symptom Signs and symptoms are diagnostic indications of an illness, injury, or condition. Signs are objective and externally observable; symptoms are a person's reported subjective experiences. A sign for example may be a higher or lower temperature ...

of Tourette syndrome, even though they are not included in the diagnostic criteria. In contrast to the stereotyped movements of other

movement disorder Movement disorders are clinical syndromes with either an excess of movement or a paucity of voluntary and involuntary movements, unrelated to weakness or spasticity. Movement disorders present with extrapyramidal symptoms and are caused by basa ...

s such as

chorea Chorea, or (rarely) choreia, () is an abnormal involuntary movement disorder, characterized by quick movements of the hands or feet. It is one of a group of neurological disorders called dyskinesias. The term ''chorea'' is derived , as the move ...

dystonia Dystonia is a neurology, neurological Hyperkinesia, hyperkinetic Movement disorders, movement disorder in which sustained or repetitive muscle contractions occur involuntarily, resulting in twisting and repetitive movements or abnormal fixed po ...

s, myoclonus, and dyskinesias, the tics of Tourette's are temporarily suppressible and preceded by this premonitory urge. Immediately preceding tic onset, most individuals with Tourette syndrome are aware of an urge, which is similar to the need to sneeze or scratch an itch. Individuals describe the need to tic as the buildup of tension in a particular anatomical location, which they consciously choose to release, as if the subject "had to do it". Examples of the premonitory urge are the feeling of having something in one's throat, or a localized discomfort in the shoulders, leading to the need to clear one's throat or shrug the shoulders. The actual tic may be felt as relieving this tension or sensation, similar to scratching an itch. Another example is blinking to relieve an uncomfortable sensation in the eye. The presence of sensory phenomena differentiates subjects with Tourette syndrome plus

obsessive–compulsive disorder Obsessive–compulsive disorder (OCD) is a mental disorder in which an individual has intrusive thoughts (an ''obsession'') and feels the need to perform certain routines (''Compulsive behavior, compulsions'') repeatedly to relieve the dis ...

(OCD) from subjects with OCD alone, and may be an important measure for grouping patients along the OCD-Tourette's disorder spectrum.

References

{{Topics related to Tourette syndrome Tourette syndrome