An Introduction to the Clinical Phenomenology of Tourette Syndrome

Histaminergic modulation in Tourette syndrome

“…Tics are defined as sudden, repetitive, non-rhythmic, involuntary movements and vocalizations [5]. The most common motor tics include eye blinking, facial grimacing, neck stretching, and shoulder shrugging, whereas vocal tics -more appropriately referred to as phonic tics as vocal chords are not always involved -are mainly represented by grunting, sniffing, and throat clearing [6].…”

“…According to the DSM-5, diagnostic criteria for TS focus on the presence of multiple motor tics plus at least one vocal tic, with onset before the age of 18 years and lasting for over a year [13]. Based on epidemiological studies mainly carried out in school-age children, TS is thought to affect between 0.3% and 0.9% of the population, with a male-to-female ratio of 3-4:1 [6,14,15]. Onset is typically in early childhood; one large multicenter study reported a mean age of onset of 6.4 years [16].…”

Language and Speech in Tourette Syndrome: Phenotype and Phenomenology

“…The epidemiological characteristics of TS have led to important advances in our understanding of associated disorders and impairments which are generally conceptualized as cooccurring conditions (comorbidity) [6][7][8][9]. While TS has attracted a number of researchers in genetics, epidemiology, neurology, neuroanatomy, and clinical management, one area that has received much less attention has been the neuropsycholinguistic features of tics and TS [10,11].…”

Kraepelin’s views on obsessive neurosis: a comparison with DSM-5 criteria for obsessive-compulsive disorder

“…[IV, 1872-3]. Although the current diagnostic zeitgeist would classify these behaviors as ''tic-like compulsions,'' 24 Kraepelin apparently considered them as tics that are related to fear (OCD-related tics). Thus, in the presence of behaviors lying halfway between compulsions and tics, modern knowledge seems to put greater emphasis on OCD, while Kraepelin differentiated between two kinds of tics-namely OCD-related tics and independent tics, which he understood as impulses or urges, not compulsions.…”

“…For instance, he recognized that compulsive acts may sometimes ''arise from pathological drives that blaze the trail forcefully'' thus being carried out ''involuntarily'' [IV, 1834], which seems to refer to the concept of complex motor tics. 24 The previous edition of DSM (DSM-IV-TR) required obsessions to cause marked anxiety and distress. In DSM-5, however, that criterion was changed to accommodate OCD patients who do not display these emotions as a result of their obsessions (e.g., patients showing disgust or incompleteness).…”