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March 21, 2022

Why Some Individuals With Tourette Syndrome Experience Assault and Perpetrate Criminal Behavior

Author Affiliations
  • 1Department of Clinical Neurosciences, Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, Alberta, Canada
  • 2Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
  • 3Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
  • 4Child Study Center, Yale University, New Haven, Connecticut
  • 5Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville
  • 6Associate Editor, JAMA Neurology
JAMA Neurol. 2022;79(5):442-444. doi:10.1001/jamaneurol.2021.5541

Tourette syndrome (TS) is now recognized as a common neurodevelopmental disorder. It has gained increasing public awareness and scientific interest worldwide. Unfortunately, tic disorders continue to be associated with significant social stigma.1 Public opinion continues to be overly focused on coprolalia,2 which is the vocal manifestation characterized by involuntary and repetitive use of obscene language. Coprophenomena (ie, other socially inappropriate behaviors),3 explosive or rage outbursts,4 intrusive echophenomena (ie, imitative behavior),5 and forced touching6 have been observed to trigger serious reactions in bystanders, especially within different social contexts.7 This, in turn, may lead to verbally abusive or violent altercations.8 Many of our colleagues overseeing tic disorder specialty clinics have anecdotally encountered patients with tic disorders who have both experienced violent assault and perpetrated criminal behavior. However, it is unknown how prevalent these issues truly are as well as whether social stigma may contribute to—and at times drive—these behaviors.

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1 Comment for this article
Differential Diagnosis
Alfred Miller, M.D. | Retired
"Lyme Disease RAGE" should be included in the differential diagnosis.

Proper testing for Neuroborreliosis should be included in the evaluation of these patients.