The Neurologic Disorders in Film
Eelco F. M. Wijdicks in Neurocinema—The Sequel, 2022
Niagara, Niagara (1997) stars Henry Thomas, Robin Tunney, Michael Parks, and Stephen Lang and was directed by Bob Gosse. Niagara, Niagara is a love story between two misfits with an unclear plotline. Tourette’s plays predominantly in this film and is the basis of violent eruptions and, eventually, a fatal outcome. Marcy (Robin Tunney) and Seth (Henry Thomas) meet while shoplifting, and their relationship progresses to drugstore holdups. The film implies that Tourette’s syndrome leads to violent behavior. Tourette’s is shown with phonic tics, and the representation is remarkable. The fact that they occur during times of personal stress is accurate. The symptoms of echolalia (imitation of sentences or sounds of others), coprolalia (expression of socially unacceptable words) and copropraxia (obscence gestures) are all shown to excess. Marcy explains that all the girls in her grammar school called her nicknames: “Mental Marcy,” “Spazzy,” and “Twitchy.” She explains that drinking helps her and “for some reason, sex helps.” She even discusses incorporating tics into a voluntary movement. At one point, she goes to a drugstore and asks for Haldol and Cogentin (appropriate medication for Tourette’s). Symptoms of obsessive-compulsive behavior are shown and explained (repeatedly tapping on her boyfriend and organizing pencils and nail-polish bottles). A major fight breaks out at the end of the film, likely to show the social difficulties implicit in the condition. (“They are calling it explosive-aggressive behavior.”)
Case 95: Trouble in the classroom
Barry Wright, Subodh Dave, Nisha Dogra in 100 Cases in Psychiatry, 2017
Transient tic disorder lasts less than a year and chronic tic disorder involves chronic multiple tics, motor or phonic but not both. Hence, Tourette syndrome (TS) is the most likely diagnosis here. This is also known as combined vocal and multiple motor tic disorder. TS starts before the age of 18, usually between 6 and 8 years of age. Under-diagnosed in some cases, there is a spectrum with many milder presentations. Tourette’s original formulation described the shouting or gesturing of obscenities (coprolalia and copropraxia), although this is not always present. This can cause considerable embarrassment and distress. The aetiology of TS remains unknown. Gene linkage studies suggest it is familial in some. Basal ganglia and autoimmune aetiologies are being researched.
Echophenomena and Coprophenomena
Alexander R. Toftness in Incredible Consequences of Brain Injury, 2023
Copropraxia is the act of making vulgar gestures when not intending to do so. Which gestures this consists of varies by culture, depending on which gestures are rude and forbidden. Many of these rude gestures involve hand signs, but other vulgar displays such as hip thrusting at inappropriate times are also reported (Lees et al., 1984). Spitting at rude times is also a behavior associated with copropraxia (Mazur, 1953). Remember, these gestures are involuntary: these people may find themselves interrupting an otherwise pleasant conversation by showing off their middle fingers.
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.
Related Knowledge Centers
- Coprolalia
- Tic
- Obscene Gesture
- Feces
- Tourette Syndrome
- Coprographia