To extend the term tic to tonic spasms such as mental torticollis,
mental trismus, or permanent blepharospasm, is singularly to
outstep the limits of its significance. We believe Erb, Troisier,
and Oppenheim are warranted in restricting convulsive tic to clonic
convulsions, and the consequent simplification and elucidation of
the question lead us to adopt the same view.
If it be solely a matter of terminology, and if universal consent
reserve tic for convulsions whose expression is clonic, we shall be the
first to withdraw the phrase "tonic tic," making the single proviso that
some other designation be found for a condition which differs from the
clonic tic only in its external features, and not in origin, pathogeny,
or treatment.
What is this other name to be? Are these tonic muscular contractions to
be regarded as synonymous with contractures? If so, do we mean
myotetanic contracture--to utilise the excellent division imagined by
Pitres--as in hysteria, or myotonic contracture, as in Parkinson's
disease? The state of muscular contraction in tonic tic does not
correspond accurately to either, though it is certainly more akin to
the myotonic form; but myotonia is a sort of _caput mortuum_ for the too
facile classification of cases in reality difficult to place, and we are
afraid the term is not calculated to ensure precision of ideas.
Should we be reproached with straining the primary meaning of the word
tic by applying it to a contraction of a certain duration, we find ample
justification ready at hand in the pages of Cruchet himself. "It was
probably in 1656," he says, "that _tique_ appeared in the French
language, in the works of Jean Jourdin." Now, in the quaint description
of the horse's _tique_ given by that writer, the signs of the disease
are said to be cocking of the ears, rolling of the eyes, clenching and
gnashing of the jaws, stiffening of the tail, nibbling at the bit, etc.
What else are these than persistent contractions or tonic tics,
alternating or co-existing with jerking movements or clonic tics?
We have no desire, of course, to over-estimate the argumentative value
of this passage, the interest of which is mainly historical; but we find
ourselves wholly in accord with Cruchet when he remarks of the
scientific distinction formulated by Willis, and again by Michael
Etmüller, between continuous, permanent tonic convulsions, and
intermittent, momentary clonic convulsions, that it is uninvolved,
practical, and of universal applicability.
In 1768 certain tics were classified among the tonic convulsions by
Boissier de Sauvages. Marshal Hall[7] gave an account of various tonic
facial convulsions to which Valleix refers as non-dolorous tics or
idiopathic convulsions of the face. Coming nearer to our own times, we
find the distinction of which we have been speaking again elaborated by
Jaccoud,[8] in 1870, and accepted also by Rosenthal.
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