Monday, May 10, 2010

An 18th Century English Author Had This Disease

A 7 year old child presents with "weird" movements and utterances. Throughout the day, he will have involuntary facial grimacing and shoulder shrugging. The symptoms wax and wane. When he concentrates really hard, he can suppress them, but otherwise, he feels an irresistible urge before the movement and great relief afterward. He says he can tell when they're coming on. His teacher has sent him home from school multiple times for saying "bad words." Review of systems is positive for restlessness, insomnia, enuresis, somnambulism, nightmares, and bruxism. His parents have observed his weird movements in his sleep. A head MRI is negative.

Challenge: The person shown in the image above also had this disease. What is it?

Image is in the public domain.

5 comments:

Eric said...

Tourette syndrome. Samuel Johnson.

Mike said...

Tourette's Syndrome

...saw in a past interview that Tim Howard of the US National Soccer team also has it as well!

Suheil said...

Classical Giles de la Tourette syndrome... though i had to google the author- Samuel Johnson ..

Elden said...

sounds like tourette syndrome.

Craig Chen said...

perfect!
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An 18th Century English Author Had This Disease

The man shown in the image is Samuel Johnson. This is Tourette syndrome, characterized by motor or vocal tics. Simple motor tics include blinking, facial grimacing, shoulder shrugging, and head jerking. Complex motor tics include bizarre gait, kicking, jumping, body gyrations, scratching, and obscene or seductive gestures. Vocal tics include coprolalia, echolalia, palilalia (repetition of a word or phrase with increasing rapidity), copropraxia (obscene gestures), echopraxia, bizarre thoughts or ideas, thought fixation, compulsive ruminations, or perverse sexual fantasies. Comorbid disorders include ADHD, OCD, learning disorder, and conduct or oppositional defiant disorder.

Sources: UpToDate; Wikipedia.