Doctor Andreas Hartmann, neurologist, is the coordinator of the Gilles de la Tourette Syndrome reference center at the Pitié-Salpêtrière hospital (Paris).
Many videos circulate on YouTube and social networks, showing people whose tics manifest themselves in insults or obscene gestures. How representative are these spectacular forms of Gilles de la Tourette syndrome (SGT)?
These manifestations of coprolalies or copropraxies (respectively obscene words or gestures) challenge, even fascinate, but are only present in a minority of our patients. For them, the number one problem is teasing, even harassment, even when the tics are “simple”. It is the reaction of others that is their main handicap. An essential message is therefore not to make fun of people with tics.
In recent months, we have seen the emergence of a rather worrying phenomenon on social networks: an “epidemic” of functional tics, that is to say false tics. I distinguish two categories. There are simulators, which stage themselves in videos to make people laugh. For a few, it is even a lucrative business, because their channels are very popular. In addition, we are witnessing a proliferation of testimonials from teenage girls on networks like TikTok. These young girls, some of whom I see in consultation, are convinced they have tics. However, their symptoms have some peculiarities: they started recently, in adolescence, which is later than usual. Their tics are often very numerous at the outset, almost always with coprolalies and copropraxies. Finally, it is mostly girls, while SGT usually affects boys four times. At the beginning, I thought that it could be atypical tics, I even started treatments, but they are in fact psychogenic tics. These young girls are not faking, these pseudo-tics are unconscious behaviors, as can be seen with abnormal movements or epilepsy. These are psychological disorders probably related to the pandemic, the anxiety and discomfort it causes.
TS is often associated with other psychiatric disorders … How to explain it?
More or less severe psychiatric comorbidities are actually present in 85% to 90% of cases. TS is the neuropsychiatric disease par excellence, at the border between two disciplines. Like autistic disorders, ADHD [trouble ou déficit de l’attention avec ou sans hyperactivité] or learning disabilities, this syndrome belongs to neurodevelopmental disorders, and there may be some common genetic basis. Tics can also be completely in the background behind other attacks.
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