It's always difficult to say whether something is a tic or an obssessive-compulsive behaviour especially with complex tics. I suspect obssessive-compulsive and TS impulses and compulsions (tics) are merely different manifestations of the same neuropathology and feel that definition is merely an academic excercise. They are there and so have to be managed and lived with unless they can be relieved by acceptable medications. Obssessive-compulsive behaviours (OCB) in TS are also often very resistant to standard OCD treatments.
Behaviours such as washing hands, being concerned about 'germs' and contamination and cleaning rituals and having to get through lots of tasks that absolutely 'must be done', e.g. before going to bed, or something bad will definitely happen are very characteristic of classic OCD. In TS, the concern with washing etc. is not often such an issue and the feeling that something bad will happen unless things are carried out the right way, is usually understood as being irrational and sometimes allows an optional aspect to the compulsion, although it may still be desirable to do in order to satisy the need or 'itch'. It is the desire for symmetry, balance and things being and feeling right that is often more important in TS (which includes tics having to feel right and satisfy a compulsion or touching and feeling things and textures in just the right way) these should properly be referred to as OC behaviours (OCB) in TS unless an individual had been diagnosed with the disorder OCD.
There is some justification for separating tourettic OCB, and to acknowledge that it is neurological in origin (and hence 'wired-in' neuro-developmentally), from psychiatric OCD which is an 'illness' that appears to have a strong psychological origin and is thus more amenable to therapy. TS is a 'spectrum disorder' in which individuals display tics and other TS behaviours and also OCB to varying extents. Some have more overt OCB than tics others lie towards the other pole and have very troublesome tics but fewer OC behaviours, some have both aspects at a high level. Many complex tics and ritualised behaviours in TS have a very strong compulsive aspect. In fact it might be argued that many other tics are compulsive in nature
