Diagnosis is primarily clinical, based on the presence of both motor and vocal tics persisting for more than a year. A thorough medical history and neurological examination are essential. Although there's no specific test for TS, doctors might use imaging studies or blood tests to rule out other conditions. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for TS include the presence of multiple motor tics and at least one vocal tic over a period of more than a year, with onset before age 18.