Variable chorea and variable tic are obviously very closely allied. The
movements of the latter, however, are distinguished by their greater
abruptness and smaller variety. They are tics by reason of their
systematisation and co-ordination; they are variable because they pass
from one region of the body to another. There is no necessary relation
between them; each has an individuality of its own and is independent of
the rest. In variable chorea, on the other hand, one movement passes
insensibly into another, and the variants of any particular one are
legion.
However easy it is, then, to separate the two clinically, it is none the
less true that they spring from the same soil of mental defect. Variable
chorea differs in nature from other choreas, though its form is the
same; it may be distinguished from tic by the type of movement, but in
essence it is identical.
CHAPTER XII
ANTAGONISTIC GESTURES AND STRATAGEMS
However harmless and insignificant a tic may be, it is a source of
annoyance to its subject of which he constantly seeks to disembarrass
himself. But the feebleness of his will militates against any sustained
effort, and if for a brief space he can conserve his immobility, victory
eludes his grasp, for his tics resume the offensive and increase in
violence. More than ever convinced of his helplessness, he resorts to
measures that serve but to accentuate the mischief. Thus it comes to
pass that he desists from his attempts at repression and admits himself
vanquished.
Some there are, nevertheless, whose inventive faculty leads them to
adopt singular attitudes, to execute curious gestures, to utilise
elaborate apparatus--proceedings always more or less childish, whose
employment is usually followed by success, but only for a time. The
history of O. acquaints us with a whole series of these subterfuges, for
which the expressive name of para-tics was invented by him, tricks
intended to mask or to modify existing tics, but they soon themselves
became as involuntary and as inevitable.
Not all who tic are imaginative enough to conceive such plans, and many
have no thought of showing fight at all, but it is worth while dwelling
on this point for a little, especially in view of the frequency with
which certain tics are accompanied by methods of correction evolved by
the patient.
Public-domain text, read in full here on John Shaqi.
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