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Why Has My Child Suddenly Developed a Tic?

Many children experience motor or vocal tics. Sudden tics may be linked to stress, illness, medications, neurologic factors, or, in some cases, an infection-triggered autoimmune response.

Medically reviewed by B. Robert Mozayeni, MD · Scientific review by Craig Shimasaki, PhD, MBA · Last reviewed August 2026

What Causes a Child to Suddenly Develop Tics?

Tic disorders, including Tourette syndrome, involve involuntary, abrupt, repetitive movements or sounds. Motor tics may include excessive blinking, eye rolling, facial grimacing, or hand gestures. Vocal tics may include coughing, throat clearing, spitting, or grunting. Tics often wax and wane and commonly first appear between ages 4 and 6.¹

The exact cause of motor and vocal tics is not fully understood. Genetics, changes in brain function, certain medications or toxins, brain injury, stress, illness, and other environmental factors may contribute. In some children, infections may trigger an abnormal immune response associated with the sudden onset of tics.

Why has my child suddenly developed a tic?

When Should Sudden Tics in a Child Be Evaluated?

Sudden tics should be discussed with a healthcare professional when they persist, worsen, interfere with daily activities, or occur along with other abrupt changes. These may include changes in behavior, mood, attention, school performance, eating, sleep, coordination, or other neurologic or psychiatric symptoms.

  • Tics that are severe, painful, or cause injury
  • Symptoms that interfere with school, sleep, or daily activities
  • Abrupt behavioral, emotional, or cognitive changes
  • New obsessive-compulsive symptoms or severe anxiety
  • Changes in eating, handwriting, coordination, or urinary frequency
  • Symptoms that appear during or shortly after an illness or infection

Can Infections Trigger Sudden Tics in a Child?

Mounting evidence indicates that infections and immune factors may play a role in the sudden onset or worsening of tics in some children, adolescents, and adults. Researchers believe that, in susceptible individuals, an infection may trigger an abnormal immune response in which antibodies mistakenly react with healthy cells in the brain. This may disrupt normal neuronal function and contribute to inflammation and neuropsychiatric symptoms, including tics.

  Evidence points increasingly toward a role for infection and immune factors in at least a subset of [Tourette’s syndrome].” 2

The concept of infections triggering motor and vocal tics is not new. In 1929, a case series was published describing three boys who developed tics following surgery for sinusitis. 3 Since then, multiple infectious agents have been linked with tic disorders.

Types of Infections Associated With Sudden-Onset Tics

For example, Group A strep infections can cause a sudden onset of tics in a child or adolescent who is genetically susceptible. In these cases, the child’s tics may be the result of a treatable autoimmune disorder known as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Strep infections (PANDAS). In fact, researchers estimate that at least 25% of children and adolescents diagnosed with obsessive-compulsive disorder (OCD) and tic disorders, such as Tourette’s, actually have PANDAS. 4

Other types of infections can trigger a sudden onset of tics in a child. These include Borrelia burgdorferi (the bacteria causing Lyme disease), mycoplasma pneumoniae, and herpes simplex virus. 5

Researchers have also found that children who had multiple strep infections were at a greater risk of developing Tourette’s syndrome when compared to those who did not have repeated infections. 6

Additionally, the enterovirus (EV) has been associated with a greater incidence of tic disorders. 8 “Our observations add to the growing body of literature implicating the immune-inflammatory process as relevant to the pathoetiology of some mental disorders,” reports Tsai and colleagues. 8

  Youth and young adults with chronic tics and OCD may have underlying infectious/immunologic etiology.” 5

Neurologic Tic Disorder or Infection-Triggered Autoimmune Process?

Making the distinction between a neurologic tic disorder and an infection-induced autoimmune disorder is important, since treatment differs for each.

In utilizing the Autoimmune Brain Panel™ (also known as the Cunningham Panel™), investigators found elevated levels of several antineuronal antibodies in patients with chronic tics and/or OCD. Elevated levels indicate that symptoms, such as tics, may be due to an infection-triggered autoimmune process. 6

The study found a “significant correlation of streptococcal-associated tics and OCD with elevated anti-D1R and anti-Lysoganglioside antineuronal antibodies in serum concomitant with higher activation of CaMKII in human neuronal cells.” 6

Feature Neurologic tic disorder Possible infection-triggered autoimmune process
Onset Tics may develop gradually or become noticeable over time and can fluctuate in severity. Symptoms may appear abruptly, sometimes with a noticeable change in behavior, mood, or other neurologic symptoms.
Recent infection A recent infection is not required for a tic disorder to develop or worsen. Symptoms may begin during or after an infection, making the timing of illness relevant to the child’s clinical history.
Other symptoms Motor or vocal tics may occur alone or with conditions such as ADHD or OCD. Abrupt tics may occur along with sudden OCD symptoms, anxiety, emotional changes, cognitive changes, sleep problems, or other neuropsychiatric symptoms.
Symptom pattern Tics often wax and wane and may become more noticeable with stress, fatigue, excitement, or illness. Symptoms may appear suddenly or worsen in association with infections or immune-related changes.
Clinical evaluation Evaluation typically considers the type of tic, duration, frequency, age of onset, family history, and other neurologic or behavioral symptoms. Evaluation may also consider recent infections, the timing of symptom onset, accompanying neuropsychiatric changes, and possible evidence of immune involvement.

Could Your Child’s Sudden Tics Be Related to Immune Dysfunction?

Take our quiz and see if your child's symptoms may be due to an underlying autoimmune dysfunction and if testing may be right for your child.

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Is your child struggling with treatment-resistant tics? It may be due to an autoimmune response.

Symptoms and Patterns to Discuss With a Healthcare Provider

What a parent notices Why it may be relevant Possible relevance of the Autoimmune Brain Panel™
An isolated motor or vocal tic Childhood tics may be temporary or part of a tic disorder. An isolated tic alone may not suggest an infection-triggered autoimmune process. Clinical history and other symptoms should be considered.
Tics that become more noticeable with stress, fatigue, excitement, or illness These factors may trigger or worsen tic symptoms. Testing may be considered when symptoms occur with other abrupt neuropsychiatric changes or a history suggesting possible immune involvement.
Abrupt tics with behavioral, emotional, or cognitive changes The broader pattern may require additional clinical evaluation. The Autoimmune Brain Panel™ may provide information about certain antineuronal antibodies and immune activity that can be reviewed alongside the child’s symptoms and medical history.
Symptoms beginning during or after an infection The timing may be relevant when reviewing the child’s medical history. A healthcare provider may consider whether testing could help evaluate a possible infection-triggered autoimmune process.
Persistent or treatment-resistant symptoms Additional evaluation may help identify contributing factors. Testing may offer additional information when symptoms remain unexplained or have not responded as expected to treatment.
Is the Autoimmune Brain Panel™ right for your child?
UPDATE REFERENCES
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders fifth edition. Washington (DC): American Psychiatric Association; 2013.
  2. Hornig M, Lipkin WI. Immune-mediated animal models of Tourette syndrome. Neurosci Biobehav Rev. 2013;37(6):1120–1138. doi:10.1016/j.neubiorev.2013.01.007 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4054816/
  3. Selling L. The role of infection in the etiology of tics. Arch Neurol Psychiatry. 1929;22:1163–1171.
  4. Westley, Erica. From Throat to Mind. Strep today, anxiety later? Scientific American. Jan. 1, 2010. https://www.scientificamerican.com/article/from-throat-to-mind
  5. Krause DL, Müller N. The Relationship between Tourette’s Syndrome and Infections. Open Neurol J. 2012;6:124–128. doi:10.2174/1874205X01206010124 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3514747/
  6. Cox CJ, Zuccolo AJ, Edwards EV, et al. Antineuronal antibodies in a heterogeneous group of youth and young adults with tics and obsessive-compulsive disorder. J Child Adolesc Psychopharmacol. 2015;25(1):76–85. doi:10.1089/cap.2014.0048 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340634/
  7. Krause DL, Müller N. The Relationship between Tourette’s Syndrome and Infections. Open Neurol J. 2012;6:124–128. doi:10.2174/1874205X01206010124 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3514747/
  8. Tsai CS, Yang YH, Huang KY, Lee Y, McIntyre RS, Chen VC. Association of Tic Disorders and Enterovirus Infection: A Nationwide Population-Based Study. Medicine (Baltimore). 2016;95(15):e3347. doi:10.1097/MD.0000000000003347 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839835/
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