Intended for healthcare professionals

Student Education

They just can't help it

BMJ 2003; 326 doi: (Published 01 February 2003) Cite this as: BMJ 2003;326:030212
  1. Mary Robertson, professor of neuropsychiatry1,
  2. Sara Alsaraf, third year medical student2
  1. 1National Hospital for Neurology, London
  2. 2Imperial College of Science, Technology, and Medicine, London

Sara Alsaraf and Mary Robertson explain Tourette's syndrome and look at the disease behind a highly stigmatised illness

Imagine you are expecting your first child. Nine months on, the miracle of having a child still overwhelms you. Your baby boy is tiny, beautiful, and full of energy.

Back at home, aged six months, his energy is unrelenting. You can't understand how something so small can make so much noise--crying, screaming all day and night, and, on top of that, making erratic and strange spontaneous movements. All babies do this, you think, it'll stop when he gets a bit older.

But it doesn't. As he grows up, the crying turns into non-stop loud and sometimes abusive talking and shouting. His boundless energy has got him in trouble at school; his teachers tell you he is violent and disruptive. And then, aged seven, you notice he has developed strange habits. He blinks constantly, sometimes rolling his eyes. He keeps sniffing and sometimes grunts. He keeps repeating the same words and phrases over and over again and sometimes will suddenly shout out offensive language. Something, you think, must be wrong with him. Confused and tired, you take him to your doctor.1 It is she who first tells you about Tourette's syndrome.

What is Tourette's syndrome?

Tourette's syndrome affects up to 1% of the British population between 5 and 17 years of age.2 The syndrome encompasses a wide range of symptoms, many of which are described by magical sounding words. A huge social stigma surrounds this disorder; many people haven't heard of it, including medical students. People think that children with Tourette's are simply odd or naughty. As future doctors we can help …

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