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Echophenomena and Coprophenomena
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
Coprolalia is when a person says something rude without willing themselves to do so. The most common examples are curse words, often with sexual connotations. When a person with coprolalia speaks, they may involuntarily add obscenities into pauses between their sentences, sometimes in a louder voice than the voice otherwise used for the conversation (Lees et al., 1984). Mental coprolalia—thinking but not saying something obscene—may sometimes be more common than verbally expressing coprolalia (Enoch & Ball, 2001).
Gilles de la Tourette’s syndrome
Published in David Enoch, Basant K. Puri, Hadrian Ball, Uncommon Psychiatric Syndromes, 2020
David Enoch, Basant K. Puri, Hadrian Ball
Coprolalia is not only a symptom of psychiatric disorders but is also a very common social “grace,” found in a proportion of the normal population. Prince (1906) distinguished the swearing of normal individuals from the automatic obscene ejaculations found in this syndrome on the grounds that the former would cease when attention was drawn to it and a conscious effort made to stop, whereas the latter were not only involuntary but persisted even when the patient made a deliberate attempt at suppression. Hughlings Jackson (1884), with his inimitable powers of observation, was of the opinion that swearing is, strictly speaking, not a part of language. He regarded it as a habit that has grown up from the impulse to add the force of passing emotions to the expression of ideas, and it belongs, therefore, to the same general category as loudness of tone and violence of gesticulation. The distinction of such utterances from language as an intellectual act may be illustrated best by the remark Dr Johnson once made to a boisterous antagonist: “Sir, you raise your voice when you should enforce your arguments.”
The psychobiology underlying swearing and taboo language
Published in Philip N. Murphy, The Routledge International Handbook of Psychobiology, 2018
Further support for this theory came from findings from aphasia patients. Aphasia is a condition in which speech and language are impaired and yet a number of case studies exist documenting people with aphasia who nevertheless have retained fluency in some more automatic aspects of language, including swearing. This is despite lesions to left cortical language areas. In a number of case reports, phrases such as “Sacre nom de Dieu”, “Jesus Christ” and “Goddammit” were reportedly preserved against a background of effortful, uncertain and dysfluent declarative speech. In addition, van Lancker and Cummings cited findings from Gilles de la Tourette’s syndrome patients which they argued implicated the basal ganglia as important brain regions associated with swearing. They cite several studies indicating that, compared with controls, the basal ganglia of Tourette’s patients showed reduced volume, higher glucose activity, diminished blood perfusion and increased dopamine receptor binding. Van Lancker and Cummings suggested that the basal ganglia form a likely origin for swearing linked with activity in the limbic system. They theorized that coprolalia (i.e., the Tourette’s swearing tic) was a type of limbic vocalization associated with a social communicative function (e.g., repulsing intruders or expressing anger) and an exemplar of the phylogenetically older speech system.
Improvement of Tourette syndrome symptoms after intractable temporal lobe epileptic surgery: a case report
Published in International Journal of Neuroscience, 2023
Fengqiao Sun, Guojun Zhang, Xiaohua Zhang
Symptoms of TS began at 16 years old, preceding seizure onset. The tics were initially characterized by various repetitive vocalizations including snorting, throat clearing, high-pitched screaming and even soliloquy, and multiple simple and complex motor tics in different body parts, such as lip-smacking, shoulder shrugging, neck turning, stereotypic hitting. Several accessory symptoms of TS such as coprolalia, echophenomenon, OCD (e.g. repetitively ensuring the door was locked), anxiety, and depression appeared simultaneously. The tic component of TS waxed and waned in severity over time, while the emotional component gradually worsened with time. Before seizure onset, the TS tics were greatly controlled for 5 years with aripiprazole and sertraline. Nevertheless, the tics relapsed upon occurrence of epileptic seizures. In the following years, tic severity varied and was aggravated by increasingly frequent seizure episodes. Neurological examinations were all normal.
Evidence-based treatment of Tourette’s disorder and chronic tic disorders
Published in Expert Review of Neurotherapeutics, 2019
Joey Ka-Yee Essoe, Marco A. Grados, Harvey S. Singer, Nicholas S. Myers, Joseph F. McGuire
Chronic Tic Disorders and Tourette’s Disorder (collectively referred to as TD henceforth) affect many children and adolescents, but prevalence estimates vary widely (0.03–5.26%) [5]. For instance, Scahill, Sukhodolsky, Williams, and Leckman [6] reported 1–2% of children are affected by TD, whereas Knight and colleagues [7] suggested that TD affects less than 1% of children. Meta-analytic investigations and expert reviews suggest the actual prevalence of TD is likely between 0.3–0.9% in children and adolescents [5,8]. For youth with TD, tics typically emerge between ages 4 and 8, and often begin with simple motor tics. Tics often progress in type and complexity to include simple vocal tics, and complex motor and vocal tics [9]. While most recognizable and socially stigmatizing, coprolalia (obscene language) and copropraxia (obscene gestures) only occurred in up to 20% of individuals with TD [10,11]. Patients with TD report that tics peak in severity during early adolescent years (around 10.5 years old), but often diminish in the late adolescence or early adulthood [12,13]. While tics are the overt behavioral characteristic of TD, many individuals with TD also report experiencing internal unpleasant sensory phenomena called premonitory urges (up to 92% of adults, and 79% of children [14–16]). Premonitory urges precede tics and are transiently reduced by the performance of tics [16,17]. The pattern of urge-relief plays an important role in the neurobehavioral treatment model of tics discussed later.