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Tourette?s Syndrome and the Law
Joseph Jankovic, M.D., Carolyn Kwak, M.S., PA-C and Richard Frankoff, J.D.
Neuropsychiatry Clin Neurosci 18:86-95, February 2006


Diminished legal responsibility and mental capacity have been used in defense of individuals with neurological disorders charged with legal misdemeanors, including criminal behavior. The purpose of this report is to 1) critically examine the mechanisms that may predispose patients with Tourette?s syndrome (TS) to potentially, legally liable behaviors; 2) report the results of a nation-wide review of state, federal, and appellate cases involving TS; and 3) instigate awareness within the professional legal community regarding unrecognized organically-based behaviors that may predispose TS patients to unwanted legal disciplinary action.

TS is a common neurological movement disorder of childhood onset associated with behavioral comorbidities, including impulse control problems, exhibition of obscene language or gestures, rage attacks, inappropriate obsessions, and other behaviors. To our knowledge, there are no studies (to date) addressing the potential impact of TS on the legal system. A comprehensive review of the neurobehavioral mechanisms underlying comorbid issues in TS is outlined. A comprehensive review of all cases tried in state and federal courts between 1985 and 2003, in which TS was somehow implicated, was conducted using the Westlaw database. As of October, 2003, TS was implicated in more than 150 cases found in the federal and state databases, 21 of which were criminal. Other cases are categorized as civil rights, criminal, education, family, labor, and social security cases.

The authors conclude that TS rarely leads to criminal behavior, but patients with TS who have behavioral comorbidities are at risk of being involved with the legal system. The medical-legal community must learn to recognize the vulnerability of this patient population to potential mistreatment by the courts of justice.


Thank you for bringing this article to our attention, HeartArt.

The very important issue of some people with Tourette has long been a concern.

Not that these are frequent occurrences, but there is always the possibility of a person with Tourette having a rage reaction, under stress in a compromising situation involving law enforcement officials and weapons.

Another potentially dangerous situation could be a person with Tourette who may express [DEF]coprolalia[/DEF] (uttering obscene language) in a situation where the motive may be understood, and there may be unwarranted retribution against the person.

The larger awareness organizations, such as the Tourette Syndrome Foundation of Canada and the Tourette Syndrome Association (U.S.A) either have educational material available or have orientation programs for law enforcement officials.

However funding and access are always an obstacle to such initiatives, therefore creating awareness at the grass roots level is relied upon.

IOW if you know someone who is a police officer, customs officer or other law enforcement official, ask them is they have a protocol for dealing with someone they suspect to be afflicted with Tourette Syndrome.

If they say no, suggest they do an internet search for Tourette information, or contact their National awareness organization.
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