Coprolalia

Captain Haddock

Coprolalia [kop-ruh-ley-lee-uh] is involuntary swearing or the involuntary utterance of obscene words or socially inappropriate and derogatory remarks. Coprolalia comes from the Greek ‘kopros’ meaning ‘feces’ and ‘lalia,’ ‘to talk.’ The term is often used as a clinomorphism (a simplification or amplification of the term for a medical condition), with ‘compulsive profanity’ inaccurately referred to as being Tourette syndrome (an inherited neurological disorder characterized by involuntary speech and movements). Related terms are ‘copropraxia,’ performing obscene or forbidden gestures, and ‘coprographia,’ making obscene writings or drawings.

Coprolalia encompasses words and phrases that are culturally taboo or generally unsuitable for acceptable social use, when used out of context. The term is not used to describe contextual swearing. It is usually expressed out of social or emotional context, and may be spoken in a louder tone or different cadence or pitch than normal conversation. It can be a single word, or complex phrases. A person with coprolalia may repeat the word mentally rather than saying it out loud; these subvocalizations can be very distressing.

Coprolalia is an occasional characteristic of Tourette syndrome, although it is not required for a diagnosis. Only about 10% of Tourette’s patients exhibit coprolalia, but it tends to attract more attention than any other symptom. The entertainment industry often depicts those with Tourette syndrome as being social misfits whose only tic is coprolalia, which has furthered stigmatization and the public’s misunderstanding of those with Tourette’s. The coprolalic symptoms of Tourette’s are also fodder for radio and television talk shows. In Tourette syndrome, involuntary outbursts, such as racial or ethnic slurs in the company of those most offended by such remarks, can be particularly embarrassing. The phrases uttered by a person with coprolalia do not necessarily reflect the thoughts or opinions of the person. Cases of deaf Tourette patients swearing in sign language have been described, showing that coprolalia is not just a consequence of the short and sudden sound pattern of many swear words. 

Coprolalia is not unique to tic disorders; it is also a rare symptom of other neurological conditions and can occur after injuries to the brain such as stroke and encephalitis, and rarely in persons with dementia or obsessive–compulsive disorder. Some patients have been treated by injecting botulinum toxin (botox) near the vocal cords. This does not prevent the vocalizations, but the partial paralysis that results helps to control the volume of any outbursts. Surprisingly, botox injections result in more generalized relief of tics than the vocal relief expected. The severity and frequency of outbursts can also be decreased by surgically disabling nuclei in the thalamus, the globus pallidus and the cingulate cortex, portions of the brain associated with motor and executive function.

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