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Coprolalia - Coprolalia Symptom, Cause, Treatment
Coprolalia comes from the Greek ??p??? meaning " feces " and ?a??a meaning "babbling, meaningless talk Coprolalia is a typical symptom of Tourette syndrome , a condition that has its onset in childhood and is characterized by compulsive arm movements, facial tics, grunting, groaning and shouting. Coprolalia is an occasional but rare characteristic of Tourette syndrome and Lesch-Nyhan syndrome patients. Aside from coprolalia, there is often echolalia, the involuntary parrot-like repetition (echoing) of a word or sentence just spoken by another person. In Tourette syndrome, compulsive swearing can be uncontrollable and undesired by the person uttering the phrases. Involuntary outbursts, such as racial or ethnic slurs in the company of those most offended by such remarks, can be particularly embarrassing.
Symptoms of Coprolalia
Persons with Tourette syndrome do not usually curse out of anger or displeasure but out of uncontrollable compulsion. Coprolalia is not used to describe contextual swearing. It is usually expressed out of social or emotional context, and may be spoken in a louder tone or different cadence or pitch than normal conditions. Coprolalia has been a recognized symptom of Tourette syndrome from the first description of the syndrome. Copropraxia is also compulsive, repetitive, and almost ritualistic in manner like coprolalia. A person with coprolalia may repeat the word mentally rather than saying it out loud. These subvocalizations can be very distressing. Copropraxia, a related complex motor tic symptom involving obscene gestures or motor tics, is also found in some TS cases.Common types of tics involving movements include:
- Eye blinking
- Grimacing
- Shoulder shrugging
- Head jerking
- Touching the nose
- In more serious cases, touching people or things, twirling around, jumping, and even self-injurious behaviors (such as hitting oneself) may be observed.
Tics involving vocalizations include:
- Repetitive throat clearing
- Tongue clicking
- Making strange or inappropriate noises such as yelping
- Repeating others' words or phrases (termed echolalia )
- Uttering swear words or racial slurs (called coprolalia , this phenomenon only occurs in about 15% of people with Tourette's Syndrome)
Causes of Coprolalia
Coprolalia is an occasional but rare characteristic of Tourette syndrome and Lesch-Nyhan syndrome patients. Coprolalia is considered a complex vocal tic and seen in a variety of neurologic disorders.
- Characterized by the presence of multiple motor tics and at least one phonic tic, which characteristically wax and wane.
- Causes and origins of Tourette syndrome have not been fully elucidated.
- A person, male or female, with the Tourette syndrome gene has a 50-50 chance of passing on the gene to each one of his or her offspring.
- The gene from one parent is sufficient to cause the syndrome.
- The Tourette syndrome gene is thus incompletely penetrant
- A higher than normal incidence of milder tic disorders and obsessive compulsive behaviors has been found in families of individuals with Tourette syndrome.
Treatment of Coprolalia
Treatment for coprolalia is primarily pharmacologic with dopamine-blocking agents and other medications. Treatment should include the following
- Some patients have been treated by injecting botulinum toxin near the vocal cords .
- Educating the patient and family about the course of the disorder in a reassuring manner.
- Completion of necessary diagnostic tests, including self-reports (by child and parents); clinician-administered ratings; and direct observational methods.
- Comprehensive assessment, including the child's cognitive abilities, perception, motor skills, behavior and adaptive functioning.
- Collaboration with school personnel to create a learning environment conducive to academic success.
- Therapy, most often behavioral or cognitive-behavioral, though other modalities may be appropriate.
- If necessary, evaluation for medication.
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