Gilles de la Tourette’s syndrome
David Enoch, Basant K. Puri, Hadrian Ball in Uncommon Psychiatric Syndromes, 2020
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.”
Neurological and neuromuscular disorders of the larynx
Declan Costello, Guri Sandhu in Practical Laryngology, 2015
Tics are abrupt, purposeless movements or vocalisations that interrupt normal motor activity. Motor tics can assume almost any form, from simple twitches or blinking to complex patterned motions like grimacing or hand gestures. Vocal tics can also be simple, such as grunting, or complex, such as meaningful phrases. In the context of otolaryngology practice, tics should remain a consideration in cases of particularly persistent throat clearing or coughing. Tics are usually suppressible to some degree, and occur along a broad clinical spectrum from mild and barely noticeable to severely disruptive and thus crippling to the patient in his daily activity. Often, they are associated with behavioural abnormalities such as obsessive compulsive disorder or attention deficit hyperactivity disorder. Gilles de la Tourette’s syndrome is diagnosed when multiple motor tics and at least one vocal tic are present for at least 1 year, beginning under the age of 21. Coprolalia, the best known feature of Gilles de la Tourette syndrome, is rare, occurring in less than 10% of cases.
The psychobiology underlying swearing and taboo language
Philip N. Murphy in 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.
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.
The concepts of heredity and degeneration in the work of Jean-Martin Charcot
Published in Journal of the History of the Neurosciences, 2020
Olivier Walusinski
On Tuesday, February 21, 1888, Charcot questioned a 21-year-old man suffering from tics: “What is more, you know that having tics in a family is not without significance. Tics are a special mark.” What followed was a thorough interrogation on personal and family antecedents. The patient, it turned out, also had a folie du doute characterized by the fear of rabies at the sight of an animal. He had two brothers and a sister with tics: “When there is one ticcer in a family, it is rarely an isolated case.” In one 1886 lesson that was not published until 1893, Charcot discussed laryngeal noises, presented as hysterical and distinct from Gilles de la Tourette disease: Mr. Gilles de la Tourette ingeniously grouped together sudden involuntary, automatic utterances that are often vulgar or obscene, but are said aloud and intelligibly, under the name of coprolalia. This often affects well-educated people with proper upbringing. … Take, for example, the case reported by Professor Pitres, of a young lady from Bordeaux, aged fifteen, with an insane aunt and a ticcer father. She herself was a ticcer who, during her fits, uttered the most filthy language. (Charcot 1893)
René Cruchet (1875–1959), beyond encephalitis lethargica
Published in Journal of the History of the Neurosciences, 2022
Olivier Walusinski
The common tic, frequently observed in children, was for Cruchet a habitual tic. Without any discussion, he cited the popular belief that a blinking ocular tic may occur following the presence of a foreign body under the eyelid or after making a game of voluntary blinking or imitating another ticcer. In a popular book published in 1911, with a second edition in 1930, Cruchet the pediatrician advised parents and teachers on “bad habits”—that is, behaviors in children that, according to him, caused lasting neuropsychiatric pathologies (Cruchet 1911). He listed the descriptions of various localizations of tics in the face and limbs, including nail-biting and trichotillomania as tics. He distinguished “visceral tics,” including snoring, sniffing, yawning, sneezing, coughing, and laryngeal and phonatory sounds, including in this last category coprolalia.
Related Knowledge Centers
- Copropraxia
- Encephalitis
- Feces
- Tic Disorder
- Tourette Syndrome
- Neurology
- Coprographia
- Taboo
- Sign Language
- Chorea-Acanthocytosis