"I swear it is Tourette's!": On functional coprolalia and other tic-like vocalizations.
Coprolalia in neuropsychiatry is typically associated with tic disorders, in particular Gilles de la Tourette syndrome. To date, there has been no report of functional coprolalia. Here, we provide the clinical characteristics of 13 adolescent and adult patients with coprolalic and other functional tic-like complex vocalizations who, on the basis of these symptoms, were misdiagnosed with a primary tic disorder, most commonly Gilles de la Tourette syndrome. We describe similarities and highlight the differences from primary tic disorders in order to provide a pragmatic list of clinical clues that will facilitate correct diagnostic labeling and thereby treatment. Finally, we emphasize that the distinction between a primary and a functional tic disorder should rely on a combination of neuropsychiatric symptoms and signs and not on the presence of single, however striking, abnormal behaviors, such as coprolalia.
Department of Neurology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany; Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute, UK.
Christos
C
Ganos
Department of Cell Sciences, St George's University of London, Cranmer Terrace, London, UK.
Mark J
MJ
Edwards
Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, d-30625, Hannover, Germany. Electronic address: mueller-vahl.kirsten@mh-hannover.de.
Kirsten
K
Müller-Vahl
D000293:Adolescent; D000328:Adult; D002648:Child; D003142:Communication; D003951:Diagnostic Errors / Q000517:prevention & control / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D000066553:Problem Behavior / Q000523:psychology*; D013981:Tic Disorders / Q000175:diagnosis / Q000523:psychology; D020323:Tics / Q000175:diagnosis* / Q000523:psychology*; D005879:Tourette Syndrome / Q000175:diagnosis* / Q000523:psychology*; D055815:Young Adult
Coprolalia; Functional neurological symptoms; Gilles de la Tourette syndrome