Gilles de la Tourette's Syndrome

The syndrome of multiple motor tics accompanied by explosive utterances was originally described by Itard (1825) and later differentiated as a syndrome by Gilles de la Tourette (1885). Koster (1899) discovered two cases among 2,500 patients admitted to a hospital for nervous diseases in Leipzig and found only 50 recorded cases in the literature available to him. Since then, cases have been reported from Germany (Strauss, 1927), Switzerland (Heuscher, 1950), Poland (Dolmierski and Klossowna, 1958), France (Seignot, 1961), Finland, (Salmi, 1961) and Canada (Baker, 1962), in addition to several from the United States and Great Britain (see below). Mahleret al.(1945) found that 18 out of 541 children admitted to a children's ward in a New York psychiatric hospital had tics, but only 11 of them suffered from “the tic syndrome” (Mahler and Luke, 1946)—a synonym for Gilles de la Tourette's syndrome. Ascher (1948) found four cases of this condition among 9,000 in-patients and 50,000 out-patients at a psychiatric centre in Baltimore. There was only one case detected among 5,300 children attending an education guidance centre in Turku, Finland (Salmi, 1961). Creak and Guttman (1935) found 14 cases in which tics were noted in the diagnosis among in-patients of the Maudsley Hospital, London, between 1932 and 1935. The rarity of Gilles de la Tourette's syndrome is such that a review of published case reports is the only feasible method of surveying the broad aspects of the condition. Three cases treated at Runwell Hospital, Wickford, Essex, and a fourth case treated personally in London are presented and published case reports reviewed.