An adolescent who repeatedly used socially unacceptable obscene words
1. 14-year old Nag was a well-behaved child all along, however, a drastic change had been noted for 6 months. He would randomly use socially unacceptable obscene or abusive words multiple times.
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1. 14-year old Nag was a well-behaved child all along, however, a drastic change had been noted for 6 months. He would randomly use socially unacceptable obscene or abusive words multiple times.
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2. Nag's parents had to face embarrassment on multiple occasions due to his use of inappropriate words. They tried their best and advised Nag to mind his choice of words and his abusive outbursts. They also checked whether one of his friends is teaching him to use foul language.
3. On the other hand, Nag found it difficult to control his language. He informed his parents the same & the fact that he too is ashamed of his behavior, however, he was unable to stop verbalizing obscene words. One month back, he developed other symptoms such as clearing throat+
4. shrugging his shoulders and blinking his eyes (he was unable to control these too).
At this stage, parents realized there could be something wrong and he was brought for consultation with me.
These symptoms were typical of a relatively common disease.
At this stage, parents realized there could be something wrong and he was brought for consultation with me.
These symptoms were typical of a relatively common disease.
5. I made a diagnosis of Tourette syndrome (also called tic disorder). Nag had both motor tics (shrugging shoulders & blinking eyes) and vocal tics (clearing throat and using obscene words).
Explained and counselled Nag's parents about the diagnosis and treatment options.
Explained and counselled Nag's parents about the diagnosis and treatment options.
6. We decided to start medical treatment for Nag, as the disease was adversely affecting his social life.
Nag showed excellent improvement in his symptoms and the family was quite pleased.
Nag showed excellent improvement in his symptoms and the family was quite pleased.
7. Take home messages
*Tourette syndrome (TS) is common & can affect 1% of children.
*Diagnosis of TS can be easily made by detailed & careful history taking.
*Treatment decision is based on symptom severity and individualized approach is needed.
*Outcome is excellent in most.
*Tourette syndrome (TS) is common & can affect 1% of children.
*Diagnosis of TS can be easily made by detailed & careful history taking.
*Treatment decision is based on symptom severity and individualized approach is needed.
*Outcome is excellent in most.
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