One of the most successful movies of 2019 is Motherless Brooklyn, directed and interpreted by Edward Norton and inspired by the namesake book, written by Jonathan Lethem 20 years earlier. The main character, Lionel Essrog, is a private detective with Tourette’s syndrome.
Is not the first time that this neurological disorder ends up in a film, let’s just think about Amadeus by Milos Forman, released in 1984, where Tourette’s is a central part of Mozart‘s life.
This syndrome had been diagnosed for the first time in 1884 by the French doctor George Gilles de la Tourette, but its causes are not utterly known, unlike the symptoms. The main stereotype concern the association with coprolalia, a compulsive behavior that forces to use foul language. Coprolalia is surely one of the symptoms, but is not the only one and it’s not that frequent. Case studies can be really different, too much to have a typification.
There are vocal and physical tics, simpler or more complex, sometimes a combination of these typologies. For example, twitches of the head, grimaces, impulses to touch or smell objects, jumping, gestures, coughing, formulation of long phrases. Coprolalia manifests itself in only 10-15% of Tourette’s cases, but statistics change from country to country: from the Japanese 4% to Costa Rican 20%. Also the number of people affected by any form of Tourette’s is uncertain, more or less 1% of the population.
As we said, there aren’t definite certainties on the origins of Tourette’s. It’s known that genetic predisposition is pivotal and that the syndrome starts from a malfunctioning of ganglia within the brain. But other theories move towards different directions, keeping in consideration also infections from a streptococcus, capable of disturbing the regular cerebral functions.
Currently, medicine can just control the symptoms, reducing the tics – strongly related to the emotional state, stress or excitement. Some therapies act on the stimuli which anticipate the tics themselves, while other treatments try to get the patient used to resist those impulses. The most serious cases require medications like muscle relaxants, only very rarely a surgical procedure is needed.
Most people, however, show a natural regression of the symptoms. Sometimes they learn how to handle it, other times they disappear with maturity, in both cases they can reduce or completely stop taking medicines.
A part from the possible pain for some moves, like suddenly turning the neck or the arms, major problems come from diseases associated to Tourette’s more than the syndrome itself. Many kids have obsessive compulsive disorders, attention deficit or hyperactivity. They may have the tendency to isolate themselves or antisocial attitude, maybe just because of the shame.
Tourette’s can show up already at 7 years old, usually before 18, but a tic is not necessarily a symptom. For Tourette’s to be diagnosed, this tic need to be repeated in time and accompanied by a vocal one too.
A normal life is more than possible, because the syndrome doesn’t undermine learning abilities. The most important thing to do is not ridiculing those affected by it, like we were in an old freak show. Of course, Mozart’s genius is out of the league, he can’t be a benchmark, nor the Venetian playwriter Carlo Goldoni can be one.
There are lots of stories of common people who are self-realized, now that there is more awareness is easier to talk about it. Sometimes a public figure can draw more attention, though, the message can be (mediatically) stronger. Whether we consider it wrong or right, it works.
Tim Howard, former Manchester United and USA national team goalkeeper, is one of the most famous cases. Sports are one of the main factor that can alleviate the symptoms, like also reading and, in general, activities which require concentration.
Howard explained that tics increased in number during top matches, too many to count them – no coprolalia, though. But only when the ball was far from his area. In the mid of the action, he focused enough to make tics disappear, his muscles “magically” relaxed.
Howard has Tourette’s since he was 9, but playing football was therapeutic to young Tim. However, the environment hasn’t always been comprehensive to his condition. In 2003, he was bought by Manchester United at 24, but many newspapers and supporters didn’t hesitate to call him “retarded” or mocking him in chants at the stadium. Things get better when he’s sold to Everton, still in England. The supporters love him and he plays better. Not only he is not ashamed anymore, but he actively raises awareness,through interviews and campaigns. “I think it’s kinda cool”, he said about his condition.
Another cool thing about him is the record at the 2014 World Cup in Brazil: 16 saves in a row against Belgium – that dominates the match but will only win after extra time.
“Guilt wants to cover all the bases, be everywhere at once”, Jonathan Lethem made Lionel Essrog say in his book. But “Guilt, like Tourettic utterance, flows uselessly”.
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