The new Tourrets’ poster child?

If you watched the Vice-Presidential debate last week, one of the things you may (or may not) have noticed was the way Sarah Palin seemed to repeatedly wink into the camera. Some pundits were focusing on that afterward noting that Governor Palin had been heavily coached and it was her way of connecting with potential voters and seeming more folksy.



However, most observers also noticed that during a lot of the debate, Governor Palin would avoid answering the direct questions of the moderator. It got me to thinking, there’s a disease where the sufferers are stricken by tics and the utterance of non-sequiters. Maybe the whole ‘winking thing’ wasn’t part of any planned strategy? Maybe we’re assigning motives to something that is more readily and easily explained? Maybe it’s actually something the campaign has gone to great lengths to hide?

Coprolalia (the spontaneous utterance of socially objectionable or taboo words or phrases) is the most publicized symptom of Tourette’s, but it is not required for a diagnosis of Tourette's. According to the Tourette Syndrome Association, fewer than 15% of Tourette's patients exhibit coprolalia. Echolalia (repeating the words of others) and palilalia (repeating one's own words) occur in a minority of cases, while the most common initial motor and vocal tics are, respectively, eye blinking and throat clearing. In contrast to the abnormal movements of other movement disorders (for example, choreas, dystonias, myoclonus, and dyskinesias), the tics of Tourette’s are stereotypic, temporarily suppressible, nonrhythmic, and often preceded by a premonitory urge. Immediately preceding tic onset, most individuals with Tourette’s are aware of an urge that is similar to the need to sneeze or scratch an itch. Individuals describe the need to tic as a buildup of tension, pressure, or energy which they consciously choose to release, as if they “had to do it” to relieve the sensation or until it feels “just right.” Examples of the premonitory urge are the feeling of having something in one's throat, or a localized discomfort in the shoulders, leading to the need to clear one's throat or shrug the shoulders. The actual tic may be felt as relieving this tension or sensation, similar to scratching an itch. Another example is blinking to relieve an uncomfortable sensation in the eye. These urges and sensations, preceding the expression of the movement or vocalization as a tic, are referred to as “premonitory sensory phenomena.” Published descriptions of the tics of Tourette’s identify sensory phenomena as the core symptom of the syndrome, even though they are not included in the diagnostic criteria.