Xiao Dong is a bright and clever little boy who just started first grade this year, but somehow he has recently caught the bad habit of blinking. He blinked even more, frowned, snorted, nuzzled, shrugged, and made strange faces, but scolding and lecturing didn’t work. His parents were so anxious that they came to the clinic the day before yesterday and the first thing they asked was, “Is this ADHD?” This is not “ADHD”, but “tic disorder”. What is tic disorder? Tic disorder is also known as Tourette’s syndrome, which is mainly manifested as involuntary, repeated and rapid twitching of one or more parts of the muscles, including blinking, eyebrow squeezing, forehead wrinkling, nose sucking, mouth opening, neck stretching, head shaking, shoulder shrugging and other manifestations. Repetitive speech, etc. Some children can be accompanied by inattention, hyperactivity, obsessive-compulsive movements and thinking or other behavioral symptoms, so much so that some parents and teachers believe that the child is disobedient, deliberately misbehaving or attention deficit hyperactivity disorder. In recent years, there has been an increasing trend in the prevalence of tic disorders. According to the clinical symptoms and course of the disease, tic disorders are broadly classified as 1) transient tic disorder; 2) chronic motor or vocal tic disorder; 3) tic-obscene syndrome, i.e. Tourette’s syndrome; 4) undetermined type. Transient tic disorder, also known as simple tics or habitual spasms in children, is one of the most common types of tic disorders, with a prevalence of about 1% to 7%, with a higher incidence in males and an age of onset of 4 to 7 years. The main clinical manifestations of this disorder are mostly simple motor tics, which are more limited. The symptoms fluctuate or shift in location within weeks or months, and may develop in the neck or upper and lower extremities. The common symptoms are blinking, eyebrow squeezing, eye rolling, forehead wrinkling, lip biting, teeth exposure, mouth opening, head nodding, head shaking, neck extension, shoulder shrugging, etc. A small number of simple vocal twitches, such as simple repeated coughing, humming or throat clearing, may occur. Twitching can be restrained by will for short periods of time (minutes to hours). The frequency and severity of twitching symptoms vary, and usually have no significant impact on the child’s daily learning and adjustment to the environment. Physical examination, including neurological examination, is usually unremarkable. The duration of the disease usually does not exceed 1 year. If the duration of the disease exceeds 1 year, it is referred to as chronic motor tics or vocal tics disorder. Tic-obscene syndrome is a chronic neuropsychiatric disorder characterized by multiple tics, bursts of vocalizations and accompanying obscene language, often accompanied by mood disorders, obsessive-compulsive symptoms or behavioral changes such as inattention and hyperactivity. The prevalence of tic-obscene speech syndrome is 0.1% to 1%. It is significantly more common in boys than in girls (about 4:1), and most of them start at the age of 4 to 12, with the most frequent onset at the age of 7 to 8. The above three types are not absolute divisions, and children who initially present with transient tic disorders may have a persistent course that progresses to chronic motor tics or vocal tic disorders. About half of the patients with Tourette’s syndrome have a simple motor tic as the first symptom, most often blinking, or a simple vocal tic as the first symptom, which presents as a Tourette’s syndrome after several weeks or months.