AS is associated with tics, Tourette syndrome and bipolar disorder. Shoulder shrugs are among the symptomatic tics of Tourette syndrome. It also has special neurologic indications for Tourette syndrome and resistant tics. It is characterized by multiple movement (motor) tics and at least one vocal (phonic) tic. Some people with Tourette's may not be aware of the premonitory urge associated with tics. Mihok says the biggest misconception about Tourette's Syndrome is about vocal tics, called coprolalia. Clonidine can be used in the treatment of Tourette syndrome (specifically for tics). Coprolalia is more likely in people with severe tics plus multiple comorbid conditions. Complex tics related to speech include coprolalia, echolalia and palilalia. Other conditions that should be considered are other neurodevelopmental disorders, tics, and sleep apnea. Klazomania is similar to other complex tics including echolalia, palilalia and coprolalia. Autoimmune processes may affect the onset of tics or exacerbate them. Johnson had a number of tics and other involuntary movements. Abnormalities in these circuits may be responsible for tics and premonitory urges. Chronic tics affect 5% of children and transient tics affect up to 20%.