The phenomenology of tics

✍ Scribed by Dr. Joseph Jankovic; Stanley Fahn

• Publisher: John Wiley and Sons
• Year: 1986
• Tongue: English
• Weight: 771 KB
• Volume: 1
• Category: Article
• ISSN: 0885-3185
• DOI: 10.1002/mds.870010103

✦ Synopsis

George Albert Eduard Brutus Gilles de la Tourette, a 28-yearqld student of Charcot, first characterized the tic disorder named after him 100 years ago (1). In his original nine cases, he pointed out that besides motor tics, seen in all patients, other peculiar symptoms were present. These included involuntary vocalizations, shouting of obscenities (coprolalia), repetition of phrases, words or parts of words (echolalia), and mimicking of gestures (echopraxia). Subsequent clinical descriptions added other characteristic features such as complex well-coordinated motor acts, obscene gestures (copropraxia), an impulsive and an obsessive-wmpulsive behavior, an attentional deficit with hyperactivity, and a sleep disturbance (2,3).

The review focuses on the phenomenology and clinical spectrum of tics. The proper recognition of the clinical characteristics of tics should help differentiate these brief in- voluntary movements fiom other muscle jerks such as myoclonus, chorea, and dystonia In addition, startle epilepsy, hyperekplexia, and a variety of peculiar culturebound syndromes will be discussed briefly because they resemble tics.

Motor tics are characterized by abrupt bursts of transient involuntary movements, usually occurring in patterned, coordinated sequences. This definition will be refined by descriiing in more detail the characteristics, distribution, timing, and severity of tics (Table 1).