Gilles de la Tourette 氏 病의 一例

A CASE OF GILLES DE LA TOURETTE ’S DISEASE ”

A clinical syndrome consisting of multiple tics was first mentioned by Itard in 1825 and subsequently recorded in greater detail by Gilles de la Tourette. He defined it as a “nervous affliction characterized by motor incoordination accompanied by echolalia and coprolalia.” It has since become known by his name. In this paper, a case of Gilles de la Tourette’s disease that was observed in a Korean boy, aged 14 was presented. The characteristic features of this case were as follows： 1) His illness began at the age of 9. Characteristic symptoms consisting of multiple tics of the face, shoulder and extremities accompanied with vocal tic were observed, and also the episodes of echolalia and coprolalia could be revealed by anamnestic history. 2) The family and developmental history revealed that the parental role was characterized by domineering, rejecting and castrating one, and the sibling relationship was also competitive and rival. In this family situation, the boy developed neurotic personality structures with obsessive feature during his early part of life. 3) In treatment, psychotherapy and the use of prop itan, a butyrophenone derivative brought to considerable effect. 4) From the genetic and dynamic view point, it was supposed that the overwhelming anxiety originated from frequently coerced separations from both of his parents since his early childhood, the castrating fear which was reinforced by his mother in later childhood and the mothering hostility and guilt fostered by these experiences were the most important factors. In his symptomatic dealing with these anxiety, hostility and guilt, it was also supp-osed to be that this boy deloped hysterical and ob- sessive-compulsive defenses simultaneously.