A little girl, Th., ten years of age, takes four or five perfectly
normal paces when she starts to walk, then bends down quickly to
the right, flexing her knee to an acute angle and inclining her
trunk forward with the deflection of her pelvis, just as a child
whose genuflexion in front of an altar has become mechanical by
repetition. The performance is sometimes so altogether sudden that
Th. actually falls on to her right side. One striking feature of
the case is that if she makes a tour of the room in order to be
observed at leisure, the inclination never fails to occur at
exactly the same point in the circuit--namely, when she is opposite
the observer. It is useless formally to interdict her from this
routine, for before one has time to notice any irregularity in the
gait her knee suddenly flexes at the bidding of an invincible
impulse, and a moment later, without any deviation from her path,
she has resumed her rhythmical step round the apartment.
This movement is not her only one, however. While she lies in bed
she can, by flexing her thigh on her pelvis, crack her joints loud
enough to be heard, and when she has been up a little while the
same action is exhibited. The absence of these cracking sounds
during ordinary walking, and their occurrence in the act of
genuflexion, very properly explain, as Oddo thinks, the origin of
the tic. It seems that the articulations at hip and knee on the
right side were affected as the result of successive attacks of
scarlatina and diphtheria two years ago, which necessitated a
prolonged sojourn in bed, and were accompanied with severe pain. It
is interesting to note that the tic made its appearance only after
the latter had considerably subsided.
Raymond and Janet[106] have reported the case of a young woman who
fell on her knees every few paces, rising again with facility and
taking a few more steps, to come down on her knees once more with a
loud noise. She never did herself any harm, however, and for that
matter the accident never occurred on a staircase or in a
unsuitable or dangerous spot.
Leaping tics are met with also.
Sometimes when walking, but more usually when standing quietly,
according to Guinon, the patients make little jumps or leaps in
their place, looking rather as if they were dancing than really
springing into the air. Some actually bound along, others run for a
yard or two.
Still more bizarre and complex tics have been described, in particular
by Gilles de la Tourette. One patient used to commence to run, then
kneel suddenly, then rise with equal abruptness. Another was in the
habit of stooping down, as if to pick something off the ground, and
smartly rising again.
Public-domain text, read in full here on John Shaqi.
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