Tourette's Disorder Logo Tourette Syndrome Tourette Syndrome is also referred to as Tourette?s Disorder, Tourettes, TS and sometimes Tourette Spectrum Disorder.


Coprolalia and Tourette Syndrome


cop·ro·la·li·a - cursing, uttering obscenities, the explosive utterance of foul or "dirty" words or more elaborate sexual, aggressive or insulting statements (e.g., racial slurs). Literally, “dung talking”, because of a compulsion to do so. The speech is not always swearing words, is neither intentional nor purposeful, and is not necessarily directed towards anyone. Pronunciation

Also see: Copropraxia, Coprographia


Coprolalia is considered a complex vocal tic and is undoubtedly the most striking, socially distressing, and dramatic symptom of Tourette Syndrome. Coprolalia is considered a complex vocal tic and is undoubtedly the most striking, socially distressing, and dramatic symptom of Tourette Syndrome. However, coprolalia is not, as many people once thought, prerequisite to the diagnosis of Tourette Syndrome.

Coprolalia is only evident among a minority of Tourette Syndrome patients, regardless it is the most popular Tourette symptom, primarily because, in the media, this rare behavior is emphasized for its sensational effect. Contrary to popular perceptions, the majority of Tourette patients do not ever exhibit this symptom.

Although Coprolalia is the most widely known symptom, coprolalia occurs in as low as 5-15% of patients and 5-30% in some clinical series. Prevalence of coprolalia varies because, not everyone with Tourette Syndrome is seen for treatment and recorded for clinical research. So there may be evidence by some reports of 8% in primary pediatric practices to over 60% in tertiary referral centers. Those figures are factored in with presumed minor cases of Tourette’s that are never seen; for this reason some figures now show prevalence of coprolalia in Tourette Syndrome as low as 5-15%.


How it works…

Editors Comments of Coprolalia disruption in Tourette Syndrome. - Paul MarshallThe coprolalia type outburst usually disrupts communication, speech, or something that a patient is involved in.  Following the disruption, the patient continues about their communication, speech, or project normally. These disruptions will usually continue to enter in and out of a patients normal behaviors and events.

For example. A patient with coprolalia could be talking with someone who mentions the word “duck”. The word “duck” trips a vocal tic in the coprolalia patient of which follows three quick vocal burst of, “fuck a duck, fuck a duck, fuck a duck”. The conversation keeps flowing as it was prior to the vocal disruption.

An observer, who is not familiar with coprolalia nor understands it, may believe the outburst is the result of a conscious and voluntary decision to swear. However the outburst are neither intentional nor purposeful.

“While obscenities and profanities may be common in everyday conversation in our culture, coprolalia is different from simply swearing or using bad language. These vocal tics usually are not uttered within social or emotional contexts, and are often spoken or repeated compulsively in a louder tone or different cadence or pitch than normal conversational speech. Particularly embarrassing for some individuals with coprolalia are involuntary outbursts within social contexts, such as racial or ethnic slurs in the company of the very people who would be most offended by such remarks.” - Understanding Coprolalia, by Sue Levi Pearl and Joanne E. Cohen


Treatment

Treatment for coprolalia is primarily pharmacologic with dopamine-blocking agents and other medications.


Course and Pathogenesis

Coprolalia tends to peak in severity during adolescence and to diminish during adulthood.

The pathogenesis may be related to dysfunction of basal ganglionic and limbic mini-circuits.


Associated Coprophenomena Conditions

Copropraxia - obscene behavior and has many variations in its expression (e.g., giving the middle finger, grabbing crotch and public sexual expressions.).

Coprographia - obscene writing or drawings (e.g., writing curse words on walls, paper, etc. for display and drawing pornographic pictures with obscenities).


In summary

Coprolalia has been a recognized symptom of Tourette syndrome from the first description of the syndrome. Coprolalia is considered a complex vocal tic and seen in a variety of neurologic disorders. The majority of Tourette patients do not ever exhibit coprolalia which only occurs in as low as 5-15% of Tourette Syndrome patients.

Edited by:

Paul Marshall
editor@tourettes-disorder.com

References

Neurol Clin. 1997 May;15(2):299-308.
Tourette syndrome. Coprolalia and other coprophenomena., Singer C.

Movement Disorders Clinic, Department of Neurology, University of Miami School of Medicine, Miami, Florida 33136, USA.

Psychology Today Magazine, Sussex Publishers
New York, NY 10010
http://cms.psychologytoday.com/conditions/tourettes.html

Tourette Syndrome Association TSA
http://www.tsa-usa.org/research/guidetodiagnosis.html

The Facts About Tourette Syndrome
http://members.tripod.com/~tourette13/FAQ/01-1.html

The Tourette Syndrome Phenomenon
http://members.tripod.com/~Mark_Kozlowski/s3.html


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Last Updated 19-Dec-2004

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