Tics vs Seizures and Other Movements: Differential Diagnosis
Author: Angela Bogdanova · Published: October 12, 2026 · Editorial Policy
Research cluster: Tic Disorders, Tourette Syndrome & Repetitive Behaviors · Written by Artificial Sapiens
A repeated blink, a sudden head jerk, a brief vocal sound, or an unusual movement can resemble a tic. Similar events also occur with epileptic seizures, myoclonus, dystonia, stereotypies, medication-related movements, and functional neurological symptoms. Distinguishing them matters because their causes, recommended investigations, safety implications, and treatment pathways can differ substantially. The central clinical question is what happens during an episode: its precise movement pattern, awareness, triggers, timing, accompanying sensations, and course over time.
Tics are sudden, recurrent motor movements or vocalizations. They are typically recognizable as repeated fragments of an individual's movement or sound repertoire, often changing in type and intensity over months or years. A seizure is a transient episode arising from abnormal excessive or synchronous neuronal activity in the brain; depending on its type, it may involve movement, sensation, behavior, awareness, or no obvious convulsion. These definitions describe different phenomena, but some episodes are genuinely difficult to tell apart. A careful history, witnessed description, clinical examination, and sometimes video-electroencephalography (video-EEG) resolve the uncertainty more reliably than an isolated symptom. European Society for the Study of Tourette Syndrome (ESSTS) assessment guideline and NICE epilepsy guidance establish the framework.
For detailed descriptions of recurrent movements and sounds, see tic symptoms and when to seek help; this article concentrates on distinguishing them from neurologic mimics.
Tics vs seizures: the most useful clinical differences
Typical tics involve brief, sudden, repetitive, usually nonrhythmic movements or sounds such as blinking, nose twitching, shoulder shrugging, head jerking, sniffing, or throat clearing. Some people experience a premonitory urge—an uncomfortable local sensation or buildup of tension—followed by temporary relief when the tic occurs. Tics can sometimes be postponed for a short time, but suppressibility varies with age, awareness, tic type, and circumstances. Suppressing a tic is not evidence that the underlying symptom is freely chosen. Tics commonly fluctuate with fatigue, attention, emotional arousal, and environment. ESSTS assessment guideline.
Seizures are extraordinarily diverse. An absence seizure may produce several seconds of interrupted responsiveness and subtle eyelid movement; a focal seizure may cause an unusual sensation, repetitive movement, behavioral arrest, or automatisms; a myoclonic seizure may consist of an extremely brief jerk; a tonic-clonic seizure may involve loss of consciousness, stiffness, rhythmic jerking, and a recovery period. Thus, a person can have a seizure without falling or convulsing. CDC classification of seizure types and ILAE childhood epilepsy syndrome classification.
The most informative distinctions are tendencies rather than diagnostic rules. Recurrent brief, variably suppressible movements with an urge and preserved interaction suggest tics. Abrupt behavioral arrest, a clear interruption of responsiveness, stereotyped epileptic episodes with consistent duration, events associated with eye closure or flashing light, an aura followed by altered behavior, or post-event confusion raise concern about seizures. Yet awareness can remain intact during some seizures, and a person with a tic may struggle to respond while concentrating on control, distraction, or distress. Nor does a seizure have to be rhythmic. Clinical interpretation depends on the complete event. NICE diagnosis and assessment.
A recurrent movement should never be classified solely because an observer thinks it looks voluntary, because it stops when the person is distracted, or because the person can describe a sensation beforehand. These properties are helpful clues within a wider assessment, not a home diagnostic test. The 2024 clinical review of tic disorders and ESSTS guideline both emphasize examination and differential diagnosis.
A practical comparison of event features
Onset and evolution: Neurodevelopmental tics often begin in childhood, usually with simple motor tics, and their repertoire evolves. Epileptic events can start at many ages and vary according to the epilepsy syndrome. An abrupt new movement in adulthood, especially with other neurologic symptoms, deserves assessment rather than automatic labeling as Tourette syndrome. CDC tic diagnosis.
Movement pattern: A typical motor tic is quick and repetitive but generally nonrhythmic. A myoclonic seizure can be shock-like and almost instantaneous; a clonic seizure produces repeated jerks with a recognizable evolution; some focal seizures feature repeated gestures or postures. The categories overlap visually, especially in short videos. ESSTS guideline and CDC seizure types.
Explore more examples of blinking, jerking, grimacing, and complex movements in motor tic examples.
Awareness and recovery: Ordinary tics generally leave awareness intact. Absence and some focal seizures may disrupt responsiveness, while other focal and myoclonic seizures preserve it. Confusion, profound sleepiness, or a marked change in behavior after an episode supports considering a seizure or another medical condition. Lack of confusion does not exclude epilepsy. NICE guidance.
Urge and control: Many people with tics notice a premonitory sensation and some temporary capacity to delay a movement. This experience becomes easier to report with development, so its absence in a young child is uninformative. The experience of control is also not completely specific to tics: many other movement phenomena fluctuate with attention or voluntary activity. ESSTS assessment guideline.
Triggers and timing: Stress, excitement, fatigue, and social context may influence tics, whereas some seizure syndromes show strong, reproducible associations with sleep-wake transitions, eye closure, or visual stimulation. A light-related association is especially important in repeated eyelid fluttering. A trigger alone never establishes the cause. ILAE epilepsy syndrome classification.
When blinking is actually a seizure
Eye blinking is a common early motor tic, which makes it a frequent source of concern for parents. It also occurs with dry eyes, allergies, visual strain, blepharospasm, stereotyped movements, and epileptic eyelid myoclonia. Most repeated blinks are not proof of epilepsy. The important question is whether the blinking has accompanying features that require neurologic investigation. Clinical report on photosensitive epilepsy mimicking blinking tics.
Epilepsy with eyelid myoclonia, previously often called Jeavons syndrome, is a recognized generalized epilepsy syndrome. Its hallmark consists of brief, repetitive eyelid jerks, often with upward eye deviation. The episodes can follow eye closure or be associated with photosensitivity, and may recur many times during the day. Awareness may be retained or subtly impaired, making a casual impression of normal interaction unreliable. An international consensus panel identified misclassification as an ocular tic as an important contributor to delayed recognition and determined that EEG is required in evaluating this syndrome. Smith and colleagues' 2023 consensus study.
In a documented pediatric case, sunlight-associated blinking was initially considered a possible tic, but video-EEG with photic stimulation demonstrated epileptic discharges correlated with eyelid jerks. A separate clinical series also described photosensitive epilepsies presenting with apparent blinking or other tic-like movements. These reports demonstrate a diagnostic possibility; case reports do not establish how common the problem is among all children who blink repeatedly. Case report and photosensitive epilepsy case series.
Particularly useful details include whether the eyes flutter immediately after closing, whether the person turns toward sunlight or a flashing source, whether blinking occurs in unusually rapid clusters, whether the eyes roll upward, and whether responsiveness changes even briefly. These are reasons for assessment, not criteria that parents should attempt to reproduce. Do not deliberately expose someone to flashing lights or intense sunlight to test for a seizure. Clinicians can evaluate suspected photosensitivity with controlled procedures and appropriate precautions. NICE guidance on EEG and provoking maneuvers.
Tics vs absence seizures and staring spells
An absence seizure often appears as a brief interruption in activity: a child pauses mid-sentence, stares, and does not respond normally. Subtle blinking or oral movements may accompany it, after which ordinary activity resumes rapidly. An observer may mistake an absence seizure for daydreaming, inattention, or unusual blinking. CDC seizure classification.
A child with a tic generally remains aware of the surroundings even while blinking or making sounds, but apparent eye contact does not establish awareness. Clinicians ask whether the child can follow a simple instruction during the exact episode, whether speech or play stops abruptly, how stereotyped each spell is, and whether many nearly identical episodes occur daily. The response should be observed, not assumed from a silent video. NICE epilepsy assessment guidance.
Absence seizures and attention problems can coexist, and a child with Tourette syndrome can also have epilepsy. The presence of a well-established tic disorder therefore does not make every new event a tic. Conversely, ordinary lapses in attention and behavioral pauses should not automatically be considered seizures. The full clinical history determines whether EEG or specialist assessment is appropriate.
The broader diagnosis and management of Tourette syndrome are covered in the separate Tourette syndrome article.
Tics vs focal seizures, automatisms, and other episodic behaviors
Focal seizures can feature repeated limb movements, facial twitching, unusual posturing, sensations, emotional experiences, automatisms such as lip smacking or picking movements, or changes in awareness. Some are brief and apparently isolated; others evolve through a sequence that witnesses can describe. A recurrent gesture should be reviewed for whether the person experiences a stereotyped sequence, an unusual preceding sensation, a change in responsiveness, or a recognizable recovery period. CDC focal seizure explanation.
Complex motor tics can also look purposeful: touching, hopping, bending, grimacing, or repeating a movement until it feels right. Their apparent meaning does not prove intention, and the complexity of an act alone does not distinguish tic from seizure. A clinician considers timing, the person's usual tic repertoire, urge, suppressibility, the complete episode, and observations by others. ESSTS assessment guideline.
An episodic movement also may be a nonepileptic paroxysmal movement disorder, sleep phenomenon, or functional neurological event. The classification matters particularly when a new episode differs markedly from an individual's previous symptoms or has occurred after a medication change or illness. A description of all observed phases is usually more valuable than a single label such as “tic attack.”
Tics vs myoclonus
Myoclonus describes a sudden, brief shock-like movement or a brief interruption of muscle activity. It is a movement phenomenology, not one diagnosis. Myoclonic jerks can occur as physiologic events, in metabolic or medication-related conditions, with movement disorders, and as epileptic seizures. Their abruptness creates genuine resemblance to simple motor tics. Clinical review of tic differential diagnosis.
Tics more often have a recognizable repertoire, some relation to an urge, and at least occasional partial suppressibility. Myoclonus is frequently extremely rapid and shock-like, with no typical premonitory tic urge. However, these distinctions depend on the condition and do not provide an absolute bedside rule. Some tic movements are so sudden that they appear myoclonic. Clinicians may use the history, neurologic examination, and electrophysiologic testing when the classification remains consequential. ESSTS assessment guideline.
A normal brief examination cannot establish that repeated jerks are harmless, especially with a new onset, loss of balance, cognitive change, systemic illness, medication exposure, or altered awareness. Such features warrant medical assessment. Where epilepsy is plausible, clinicians select EEG methods based on the history rather than ordering a routine EEG as a universal tic test. NICE assessment guidance.
Tics vs dystonia and blepharospasm
Dystonia causes patterned, sometimes twisting muscle contractions or postures and may involve specific tasks or muscle groups. A prolonged neck, shoulder, or trunk tic can resemble dystonia; clinicians sometimes describe such a tic as dystonic in its movement quality. Conversely, a dystonic movement may be mistaken for a complex motor tic. The associated history, sustained abnormal posture, pattern of muscle activation, sensory phenomena, and the rest of the neurologic examination guide differentiation. ESSTS guideline.
Blepharospasm involves involuntary contractions around the eyelids and can produce frequent blinking or forceful eyelid closure. In adults with new excessive eye squeezing, it is particularly important to consider blepharospasm and ocular conditions rather than assuming a childhood-onset tic syndrome. A clinician may ask about light sensitivity, dry eyes, visual irritation, and the distribution of facial contractions. Review of tic diagnosis and management.
Medication-induced dystonia, including an oculogyric crisis involving sustained abnormal eye position, may call for timely medical management. Recent use or dosage changes of dopamine-blocking medications and other relevant drugs therefore belong in the assessment. Do not discontinue prescribed medicine based on a movement-label guess; contact the treating clinician promptly when a potentially drug-related movement develops. ESSTS differential assessment.
Tics vs chorea, tremor, and other movement disorders
Chorea consists of irregular, unpredictable movements that appear to flow from one body region to another; an isolated abrupt choreic movement can resemble a tic. Tremor is generally an oscillatory movement, often rhythmic, and differs from most tics in its ongoing pattern. Akathisia is a distressing sense of inner restlessness associated with a drive to move, frequently relevant when reviewing medications. These descriptive distinctions provide an initial clinical vocabulary; neurologic evaluation determines their significance. ESSTS assessment guideline.
Movement disorders may be primary, medication-associated, metabolic, genetic, or linked to other neurologic illnesses. A typical history of childhood-onset waxing-and-waning tics often needs limited testing. A progressive disorder, unusual gait changes, new weakness, changes in cognition, or abnormal neurologic findings requires a broader assessment. Update on tic disorders.
Tics vs stereotypies, stimming, and habits
Stereotypies are repeated, relatively fixed patterns of movement, such as rocking, finger movements, or hand flapping, often beginning early in development. They may be rhythmic, occur during excitement or absorption, and respond to interruption or distraction. Tics tend to begin later in childhood, may change their movement repertoire, and are often accompanied by premonitory urges when the person is old enough to recognize them. Both can coexist in the same individual. A 2024 systematic review examined this co-occurrence, and the ESSTS assessment guideline details typical differences.
Stimming refers more broadly to repetitive sensory or motor activity that may serve self-regulation, pleasure, concentration, or communication. It is often discussed in autistic communities, but a repetitive movement alone cannot establish autism, a tic disorder, or a particular regulatory purpose. Distinguishing a tic from stimming requires attention to the person's experience, developmental history, context, and observable pattern. The dedicated tic-first comparison in the EN-21 knowledge network will address this in further depth; it is not yet a live link.
Habits and ordinary reflexes also need consideration. Throat clearing may reflect irritation, reflux, allergy, or a vocal tic; repeated blinking may respond to an eye problem; repetitive tapping may be habitual. The clinician first identifies the actual phenomenon and its possible physical contributors rather than assigning a psychiatric or neurologic diagnosis from its appearance. Pediatric tic-assessment review.
Tics vs compulsions and body-focused repetitive behaviors
A tic often relates to an immediate sensory urge and momentary relief. A compulsion is commonly performed according to a rule or to respond to an intrusive fear, distress, or sense of incompleteness, although the subjective motives can overlap. Repeated touching, tapping, counting, or “just-right” behaviors can therefore be difficult to classify. Tourette syndrome and OCD may also coexist, requiring attention to both symptom types. The recent 2025 review of repetitive behavior distinctions explains the overlap and its limitations.
Hair pulling and skin picking involve distinct clinical assessment and belong to the body-focused repetitive behavior and OCD-related literature. They should not be equated automatically with motor tics. For the full OCD-first discussion, see OCD vs Tourette syndrome: compulsions, tics, urges, and related OCD and OCD and body-focused repetitive behaviors.
Neurodevelopmental tics vs functional tic-like behaviors
Functional tic-like behaviors are real, often involuntary and distressing symptoms associated with functional neurological disorder presentations. In some cohorts, they have developed abruptly during adolescence or young adulthood, become complex and intense quickly, and differed from the slower childhood evolution commonly seen in Tourette syndrome. A functional diagnosis requires a positive clinical formulation supported by the overall examination and history, rather than a conclusion that testing was normal or that symptoms are fabricated. ESSTS expert consensus and Dean and Torbey's 2025 clinical review.
Proposed expert criteria for functional tic-like behaviors use age of onset, rapid evolution, phenomenology, and other clinical characteristics. These are expert consensus criteria, not validated diagnostic tests with established sensitivity and specificity in every clinical population. Research has also raised concerns about possible circularity and over-reliance on demographic patterns. Age, gender, social-media exposure, and apparent complexity must never substitute for individualized assessment. Pringsheim and colleagues and critical appraisal in Movement Disorders Clinical Practice.
Both neurodevelopmental tics and functional tic-like symptoms may occur in one person. Management is tailored to the established clinical formulation: treatment evidence for CBIT in chronic tic disorders cannot automatically be transferred to every functional presentation, and an epilepsy treatment pathway cannot be replaced by a psychological intervention when seizures are suspected. The goal is accurate recognition and appropriate, respectful care. 2025 review.
When a possible tic requires urgent assessment
Call emergency services for a seizure lasting more than five minutes, repeated seizures without recovery, significant injury, difficulty breathing or waking, or a seizure in water. In the United States, call 911 for a first seizure and the additional high-risk situations identified by the CDC. During a convulsive episode, clear hazards, cushion the head, turn the person gently on their side when feasible, time the episode, and avoid restraining movements or placing anything in the mouth. CDC seizure first aid.
Arrange prompt medical assessment for new repeated episodes of unresponsiveness, persistent focal weakness, unexplained loss of consciousness, unusual changes in behavior or cognition, new movement symptoms after starting a medication, or a rapidly changing or atypical movement presentation. A first suspected seizure merits urgent specialist evaluation; NICE recommends assessment within two weeks in its clinical system. Local referral pathways and emergency thresholds vary. NICE guidance.
An established tic disorder does not eliminate the need to investigate a new seizure-like episode. Equally, a harmless-appearing repetitive movement does not automatically justify an emergency visit. Seek clinical guidance based on the event's complete features and the person's condition.
How clinicians evaluate unusual movements
1. Establish the timeline and developmental history
The clinician asks when the movements first appeared, whether they evolved gradually or suddenly, whether there have been motor and vocal symptoms, how long each event lasts, how often it recurs, and whether the repertoire changes over time. They review prior diagnoses and family history, pregnancy and developmental factors where relevant, sleep, illness, medication exposure, stimulants or other substances, and possible neurologic symptoms. Historical childhood tics are particularly important when symptoms are currently being assessed in adulthood. CDC diagnostic framework and ESSTS assessment guideline.
2. Describe the event without prematurely naming it
The examiner asks witnesses what happens immediately before, during, and after an episode: the first movement, direction and sequence of jerks, gaze, speech, posture, responsiveness, color or breathing changes, triggers, injuries, and recovery. The person is asked about sensations, urges, awareness, efforts to delay the movement, and fatigue afterward. This structured account is essential because clinic visits may not coincide with an episode. NICE first-seizure assessment.
3. Review safe home videos if available
A short recording may show movement rhythm, eye deviation, behavioral arrest, responsiveness, and recovery more clearly than memory alone. Record only if it is safe and does not delay first aid; never deliberately induce an episode to obtain footage. Include the whole event, surrounding context, and an audible description where possible. A video informs a clinician but cannot reproduce EEG evidence or replace a medical examination. NICE recommendation on eyewitness accounts and footage.
4. Perform a physical and neurologic examination
The assessment may include eye and movement examination, muscle tone, coordination, gait, neurologic signs, physical contributors to blinking or throat clearing, and review of medications. The clinician also considers function, distress, sleep, and possible associated ADHD, OCD, anxiety, or autism when relevant. A tic severity scale quantifies burden; it is not a test that distinguishes seizure from tic. ESSTS assessment guideline.
The assessment role and limits of the YGTSS severity scale are explained in the dedicated scale guide.
5. Select testing according to the differential
A typical uncomplicated childhood tic pattern does not automatically require EEG or brain MRI. Where episodes suggest epilepsy, clinicians may use routine EEG and, if needed, sleep-deprived, ambulatory, or video-EEG approaches to seek correlation between the observed event and electrical activity. A normal interictal EEG cannot exclude epilepsy; neither an abnormal EEG in isolation nor a single recording necessarily explains every movement. In suspected epilepsy with eyelid myoclonia, an EEG is particularly important. NICE epilepsy diagnosis guideline and 2023 expert consensus.
Brain MRI, blood testing, ECG, ophthalmologic assessment, medication review, or other investigations become appropriate when indicated by the event and the patient's findings. MRI looks for selected structural causes; ECG is relevant when transient loss of consciousness could be cardiac. The decision follows clinical evidence, not the desire to order every available test. NICE specialist-assessment pathway.
Why the distinction changes treatment
When a clinician confirms a neurodevelopmental tic disorder, education, support, assessment of impairment, and sometimes watchful waiting are appropriate. Comprehensive Behavioral Intervention for Tics (CBIT) is an evidence-based behavioral intervention when treatment is desired or impairment warrants it. Medication can be considered after discussion of expected benefits, adverse effects, and coexisting conditions. A tic intervention aims to reduce distress or impairment; it is not an epilepsy treatment. American Academy of Neurology practice guideline and CDC tic treatment.
For a fuller discussion of accommodations and everyday coping, see daily strategies for managing tics.
When seizures are diagnosed, evaluation concerns seizure type, epilepsy syndrome, safety, and individualized antiseizure treatment. In a suspected first seizure, starting medication is a specialist decision guided by the likelihood of recurrence, EEG or imaging evidence where relevant, and the person's circumstances. Treatments suitable for one epilepsy type can be inappropriate for another. NICE diagnosis and NICE treatment principles.
For dystonia, medication-related movements, stereotypies, functional symptoms, or sensory-driven repetitive behaviors, care targets the correct presentation and its consequences. Functional symptoms warrant explanation and tailored rehabilitation or psychological approaches as indicated; clinicians should also assess any coexisting tic disorder. An accurate differential prevents both unnecessary investigations and missed medical care.
What families and adults can do before the appointment
Keep a neutral, factual record of when the episode occurs, its duration, context, awareness, triggers, recovery, and effect on daily functioning. Write down new medications and dose changes and ask teachers, partners, or other witnesses for direct descriptions. If an episode is safe to film, a short recording may be useful. Avoid asking a child to repeatedly perform, suppress, or demonstrate a movement; pressure, embarrassment, and unsafe attempts to recreate a spell can make assessment harder.
When seizures are a realistic possibility, seek timely clinical advice about activities where sudden loss of awareness could cause serious injury, including swimming, bathing alone, heights, and operating vehicles. Restrictions should be individualized under medical advice and local regulations rather than assumed from the appearance of a movement. When tics cause discomfort or interference, ask about support and evidence-based tic-specific care. NICE epilepsy safety guidance and AAN tic management guideline.
Frequently asked questions
Can a seizure look exactly like a tic?
Yes. Very brief motor seizures, especially some eyelid myoclonia episodes, may closely resemble blinking tics. Distinguishing them may require careful observation and EEG, particularly when events occur with eye closure, light exposure, or changes in awareness. International expert consensus.
Can a person have both tics and epilepsy?
Yes. These are distinct diagnoses, and one does not exclude the other. A new episode that differs from someone's usual tics deserves its own evaluation. A clinician should not automatically assign every unusual movement to the previously known condition.
Do tics cause loss of consciousness?
Typical motor and vocal tics do not cause loss of consciousness. Apparent fainting, unresponsiveness, or post-event confusion raises the need to assess seizures, syncope, and other explanations. Some seizures retain awareness, so preserved awareness alone is insufficient to exclude them. NICE guideline.
Can someone suppress a seizure as they might suppress a tic?
Temporary voluntary suppression favors some tic presentations, but the absence or presence of apparent control cannot classify an episode on its own. Individuals may alter behavior in anticipation of an event, and some episodes vary with attention. The full history, clinical signs, and indicated testing determine the interpretation. ESSTS assessment guideline.
Can tics happen while someone is asleep?
Tics usually decrease during sleep but can persist. Movements during sleep also include normal sleep-related jerks, parasomnias, sleep-related movement disorders, and seizures. Video history, associated signs, and sleep or neurologic assessment may be needed in unusual cases. ESSTS assessment guideline.
Does a normal EEG rule out epilepsy?
No. A normal routine EEG between events does not exclude epilepsy. Clinicians decide whether additional testing such as sleep-deprived, ambulatory, or video-EEG is appropriate using the clinical history. NICE diagnosis and assessment.
Should everyone with eye blinking get an EEG?
No. Many causes of repeated blinking are non-epileptic. EEG is selected when history or examination raises suspicion of seizure activity, especially with highly stereotyped rapid eyelid fluttering, photosensitivity, eye closure induction, or interrupted responsiveness. NICE guideline and eyelid myoclonia consensus.
What if sudden tic-like movements appear for the first time in adulthood?
A clinician should review medications, neurological findings, functional symptoms, metabolic causes, and other movement disorders, along with any overlooked childhood tic history. An adult's symptoms should be evaluated on their merits rather than assumed to be late-onset Tourette syndrome. ESSTS assessment guideline.
For the specific adult presentation and referral pathway, read about new-onset tic-like movements in adults.
Are functional tic-like behaviors consciously produced?
Functional tic-like behaviors are clinically recognized symptoms that can be involuntary and disabling. The diagnostic approach considers positive clinical features and an individual's history. Demographics, social media, and negative tests do not establish deception. ESSTS consensus.
Is CBIT appropriate when an episode might be a seizure?
CBIT is an established treatment option for impairing neurodevelopmental tics. It is not a substitute for assessing suspected epilepsy, and the evidence cannot be transferred automatically to other movement phenomena. Accurate diagnosis and coordinated care come first. AAN guideline.
Conclusion
The difference between a tic and a seizure emerges from the whole episode: onset, movement pattern, awareness, urges, triggers, duration, recovery, developmental history, and clinical findings. Eye blinking deserves particular attention when it follows eye closure, clusters with unusual speed, occurs with light exposure, or interrupts responsiveness. Myoclonus, dystonia, stereotypies, functional symptoms, compulsions, and medication-related movements require their own clinical consideration. The most useful next step is a careful, nonjudgmental assessment proportionate to the actual signs and risks.
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References
Burlo, F., Barbi, E., Carrozzi, M., & Zanus, C. (2022). Case report: A relevant misdiagnosis: Photosensitive epilepsy mimicking a blinking tic. Frontiers in Pediatrics, 10, 918420. https://doi.org/10.3389/fped.2022.918420.
Cavanna, A. E., Purpura, G., Riva, A., & Nacinovich, R. (2024). Co-morbid tics and stereotypies: A systematic literature review. Neurological Sciences, 45, 477–483. https://doi.org/10.1007/s10072-023-07095-y.
Centers for Disease Control and Prevention. (2024). First aid for seizures. https://www.cdc.gov/epilepsy/first-aid-for-seizures/.
Centers for Disease Control and Prevention. (2024). Types of seizures. https://www.cdc.gov/epilepsy/about/types-of-seizures.html.
Centers for Disease Control and Prevention. (2026). Diagnosing tic disorders. https://www.cdc.gov/tourette-syndrome/diagnosis/index.html.
Dean, S., & Torbey, S. (2025). When it's not tics: Functional tic-like behaviors. Psychiatric Clinics of North America, 48, 151–163. https://doi.org/10.1016/j.psc.2024.09.001.
Desai, I., Kumar, N., & Goyal, V. (2023). An update on the diagnosis and management of tic disorders. Annals of Indian Academy of Neurology, 26(6), 858–870. https://pmc.ncbi.nlm.nih.gov/articles/PMC10789408/.
Ganos, C., Münchau, A., & Bhatia, K. P. (2014). The semiology of tics, Tourette’s, and their associations. Movement Disorders Clinical Practice, 1(3), 145–153. https://doi.org/10.1002/mdc3.12043.
Katz, T. C., Khan, T. R., Chaponis, O., & Tomczak, K. K. (2025). Repetitive but not interchangeable: Similarities and differences in the repetitive behaviors of Tourette syndrome, obsessive-compulsive disorder, Tourettic obsessive-compulsive disorder, and autism spectrum disorder. Psychiatric Clinics of North America, 48, 165–180. https://doi.org/10.1016/j.psc.2024.09.002.
Longardner, K., Desai, S., Nespeca, M., Bainbridge, M., & Friedman, J. (2020). Photosensitive epilepsy syndromes mimicking motor tics. Movement Disorders Clinical Practice. https://pmc.ncbi.nlm.nih.gov/articles/PMC7525200/.
National Institute for Health and Care Excellence. (2025 update). Epilepsies in children, young people and adults: Diagnosis and assessment of epilepsy (NG217). https://www.nice.org.uk/guidance/ng217/chapter/diagnosis-and-assessment-of-epilepsy.
National Institute for Health and Care Excellence. (2025 update). Epilepsies in children, young people and adults: Principles of treatment, safety, monitoring and withdrawal (NG217). https://www.nice.org.uk/guidance/ng217/chapter/principles-of-treatment-safety-monitoring-and-withdrawal.
Pringsheim, T., et al. (2023). European Society for the Study of Tourette Syndrome 2022 criteria for clinical diagnosis of functional tic-like behaviours: International consensus from experts in tic disorders. European Journal of Neurology, 30, 902–910. https://doi.org/10.1111/ene.15672.
Pringsheim, T., Okun, M. S., Müller-Vahl, K., et al. (2019). Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders. Neurology, 92(19), 896–906. https://doi.org/10.1212/WNL.0000000000007466.
Smith, K. M., et al. (2023). Clinical presentation and evaluation of epilepsy with eyelid myoclonia: Results of an international expert consensus panel. Epilepsia, 64, 2330–2341. https://doi.org/10.1111/epi.17683.
Specchio, N., et al. (2022). International League Against Epilepsy classification and definition of epilepsy syndromes with onset in childhood: Position paper. Epilepsia. https://doi.org/10.1111/epi.17241.
Szejko, N., Robinson, S., Hartmann, A., et al. (2022). European clinical guidelines for Tourette syndrome and other tic disorders—Version 2.0. Part I: Assessment. European Child & Adolescent Psychiatry, 31, 383–402. https://doi.org/10.1007/s00787-021-01842-2.