Talk:Tourette syndrome/Archive 3

Nicotine
I took the link to the nicotine page to read about this substance as this article on Tourette Syndrome says that physicians caution against using it to treat Tourette's because of its carcinogenic traits. However, the nicotine page states in its introduction that the substance is not carcinogenic. An inconsistency of 'fact'-stating that perhaps should be cleared up?


 * Doesn't matter. More importantly, nicotine is not effective in treating Tourette's.  Sandy 00:06, 6 February 2006 (UTC)
 * On a related note I removed the reference in the Marinol paragraph about the animal studies that showed that nicotine and Marinol are effective adjucts in treating TS for these reasons: First, I think the fact that it is about both Marinol and nicotine confuses things.  Second, it is not really a study on Marinol or nicotine monothearpy, it is a study on using them as an adjuct to neuroleptics.  Third, and most importantly, it is only an animal study and therefore proves nothing about treating humans with TS.
 * —Preceding unsigned comment added by 206.59.61.72 (talk • contribs) 01:50, 15 February 2006 (UTC)

The first sentence in the Experimental treatments section refers to nicotine. It quotes Swerdlow's 2005 paper (see references). His specific words are: "Consequently, drugs often reported to be effective in individual cases or case series fail in controlled trials. One notable example is nicotine, which produced profound and prolonged tic reduction in case reports, but these effects were not reproduced in the first controlled trial reported 13 years later." Unsigned user, please explain why you continue to edit the entry ? The addition of the word "patches" adds what for the reader? I will change it back. Sandy 00:47, 16 February 2006 (UTC)
 * I'm not trying to promote nicotine thearpy at all I hope you realize. I just thought "patches" would be more precise, because there are other ways of consuming nicotine.  You can also smoke, or use the gum.  Just saying nicotine doesn't make it clear to the reader that nobody has ever suggested that people with TS smoke, for example.206.59.61.72 18:14, 16 February 2006 (UTC)


 * By restricting the discussion to "patches", on the other hand, you are talking about a delivery system rather than the actual ingredient. The more correct statement is about the ingredient, not the delivery vehicle.  Sandy 19:00, 16 February 2006 (UTC)

Hi all...my name is Mike DeFilippo and I just wanted to add that recent studies done at Johns Hopkins have shown nicotine to be helpful in reducing tics and helping with depression. I, for one, can vouch for this. I have attempted to quit smoking in the past and have noticed that when I am wearing the patch I do tic less. Now you have to realize that in my mind I thought that I would be a veritable tic machine if I wasn't smoking; on the contrary, before I even heard about these studies I found that wearing the nicotine patch did reduce my desire to tic. In hindsight, I realize the patch does help somewhat; it isn't a cure by any means, but it certainly helps to an extent, and I am sure the extent to which it helps will differ from person to person. I was diagnosed in 1998 at the age of 40 and have published an educational book on Tourette syndrome called Getting Personal, Stories of Life with Tourette Syndrome. Please feel free to e-mail me at any time at mike@secondchancepublishing.com.--Mike 21:55, 21 March 2006 (UTC)


 * Hi, Mike. I've not encountered a controlled study (or otherwise) that shows nicotine to be helpful in controlling tics:  can you provide us with some reference, for example, a PubMed abstract for the study you're referring to ?  Sandy 23:34, 21 March 2006 (UTC)

I don't have the actual study name, but there are a couple of Web sites easily available in any search engine that do discuss them. You could check these and do a little more research on your own.

http://www.tourettes-disorder.com/therapy/nicotine.html

http://news.bbc.co.uk/1/hi/health/1549392.stm

Hope this helps.


 * Hi, Mike. Thanks for responding.  The first site you referenced is written by a layperson, and not a good source of reliable information.  The second site you give is a news, media report.  Neither of them are good sources of veriable medical information, or controlled studies.  I am not aware of any controlled studies showing nicotine to be useful in the treatment of Tourette's tics.  Since you mentioned that, "I just wanted to add that recent studies done at Johns Hopkins have shown nicotine to be helpful in reducing tics and helping with depression," it would be helpful if you could produce this controlled, blinded study?  For background info, here is the controlled, blinded study which was done, which found nicotine to be ineffective as monotherapy for Tourette's (although the results are cleverly worded by the study authors, to eek some usefulness out of the study).    "Transdermal nicotine was superior to placebo in reducing behavioral symptoms when patients were receiving an optimal dose of haloperidol, when the dose of haloperidol was reduced by 50%, and when the patch had been discontinued for 2 weeks. These findings confirm earlier open-label findings and suggest that combining nicotinic receptor modulation and neuroleptics could be a therapeutic option for the treatment of Tourette's disorder. "  Which means, if you take it with haldol, it may help with behavioral symptoms, which may or may not be associated with Tourette's.  From a journal-published report:  Tourette Syndrome: Current Controversies and the Battlefield Landscape, Neal R Swerdlow MD PhD, Current Neurology and Neuroscience Reports 2005, 5:329-331, "Drugs often reported to be effective in individual cases or case series fail in controlled trials. One notable example is nicotine, which produced profound and prolonged tic reduction in case reports, but these effects were not reproduced in the first controlled trial reported 13 years later."  Sandy 12:20, 24 April 2006 (UTC)

Should we include Dr. Tourette's full name?
I used to think that his full name was Gilles de la Tourette. Then I found out that it was Georges Gilles de la Tourette. Then I found out (in the wiki article about him) that his full name was Georges Albert Édouard Brutus Gilles de la Tourette.

He had a very long name. How much of it should we put into this article? Maybe someone who speaks some French could help us.206.59.61.72 22:47, 15 February 2006 (UTC)


 * His name makes sense to me, but I speak other languages and am accustomed to longer names. Think in terms of "de la."  I don't know if it matters what is on the picture caption, since his full name is specified in the text ??  Sandy 23:13, 15 February 2006 (UTC)
 * I should clarify further: for contemporary English-speaking purposes, his last name is Gilles de la Tourette, and his first name is Georges.  His full name is included in the Wikipedia article about him, but not on the Tourette syndrome article.  It could also be included in the text here, but may confuse people who aren't accustomed to longer names, as it did you ??  Sandy 17:11, 16 February 2006 (UTC)


 * With a name like that he was probably an aristocrat which usually have very long names with the distinctive de which is often the name of a village or town of which they marquis, conte or baron, I think we should include his complete name--Khalid hassani 00:07, 17 February 2006 (UTC)
 * Well, not everyone who has a de in their long last name is an aristocrat, but I added it since several have raised the need. Thanks !  Sandy 00:12, 17 February 2006 (UTC)
 * Today yes, but not a that time in my opinion, anyway in France aristocracy has been officially abolished, those who persist calling someone marquis or baron are acting by mere folklore --Khalid hassani 22:28, 18 February 2006 (UTC)

Verifiable, reliable sources
Returning to the issue of verifiable and reliable sources. Because Oliver Sacks' fictionalized writings are not subject to peer review, they may need to be placed in context for a medical article. That is, the factual basis for his descriptions of fictionalized characters should be established, particularly since not all TS professionals agree with all of his views and statements about Tourette's. Attempting to establish that the fictional character "Carl Bennett" was based upon a real person, I included mention of Mort Doran in the following sentence:

Neurologist and writer Oliver Sacks describes a physician with severe TS, (Canadian Mort Doran, M.D., a pilot and surgeon in real life, although a pseudonym was used in the book), whose tics remit almost completely while he is performing surgery.

I found my reference, which is Morton L. Doran's bio from a TSA conference. He has spoken at many TSA conferences, evidenced by Google Groups posts to alt.support.tourette, the newsgroup. I don't know how to cite a conference, so I am including the information here, hoping someone will help with how to cite it.

The Tourette Syndrome Association, Inc., Connecticut Chapter 1998 Educators' Conference Understanding and Managing Tourette Syndrome, and the Associated Disorders, Obsessive Compulsive Disorder & Attention Deficit Hyperactivity Disorder in the Classroom. Friday, November 6, 1998 With Keynote Speaker Morton L. Doran, MD, Surgeon written about in The Man Who Mistook His Wife for a Hat by Oliver Sacks, MD at Western Connecticut State University Westside Campus, Danbury, CT "This year's keynote speaker is Morton L. Doran, MD. Dr. Doran is a practicing surgeon, professor of medicine and recreational pilot who has had Tourette Syndrome since early childhood.  He was featured in a book, The Man Who Mistook His Wife for a Hat by Oliver Sacks, MD, a perceptive look at living successfully with neurobiological disorders.  Dr. Doran was the featured surgeon in New Yorker magazine's article about a surgeon with TS.  He is a dynamic and highly respected spokesperson for the Tourette Syndrome Association in the USA and Canada." —Preceding unsigned comment added by SandyGeorgia (talk • contribs) 16:52, 16 February 2006
 * Francis, thanks for adding my sig back in after you accidentally took it out :-)) Sandy 14:05, 17 February 2006 (UTC)
 * Not sure it's right, but I did it. Sandy 00:18, 20 February 2006 (UTC)

Comment. I have just found out that the above bio was incorrect, and have changed the references accordingly. Carl Bennett/Mort Doran was described in The Surgeon's Life chapter of The Anthropologist from Mars, while Witty Ticcy Ray (the drummer) was described in The Man Who Mistook ...  It looks like the person who prepared the above conference bio simply mixed up the two books. Here are the tables of contents from each book:

Anthropologist... TOC and [http://search.barnesandnoble.com/booksearch/isbninquiry.asp?z=y&ean=9780684853949&displayonly=TOC#TOC The Man Who Mistook... TOC] Sandy 04:21, 7 June 2006 (UTC)

Mediation
Hi, I'm your friendly cabal mediator. Sandy has requested mediation on this page. This isn't any kind of formal thing, well it will probably fluctuate in formality. The most important thing is that I'm not here to pass judgement or place blame, I'm just a third person who will attempt to look at your dispute in an impartial fashion and try and help you build consensus.

To the anonymous user, could you please outline your side of the story on the mediation page, thanks! :) - FrancisTyers 11:14, 16 February 2006 (UTC)


 * Ok, first thing I'd like to see is some kind of precedent for either of your points of view. Check out the Wikipedia articles on other neurological disorders and see how they deal with experimental treatments. I note that the page on Parkinson's disease does not have any information on experimental treatments, however the article on Multiple sclerosis mentions Cannabis but only briefly (one sentence). Please try and be terse, limiting yourself to listing the article and its position. I may move discussion that strays from the point. - FrancisTyers 23:02, 16 February 2006 (UTC)


 * Okay, well there were three articles. The first was a study of 12 people that found that Marinol was effective for TS and have very few adverse effects.  The Second was about a longer larger study that had the same conclusion, and noticed that Marinol's effectiveness increased the longer people took it.  The third paper noted that people with TS taking Marinol experienced a general trend toward improving their cognative functioning.  These studies were funded by the TSA.  I realize that the summary of the studies sounds NPOV, but if you look at the actual abstracts, I am not making any exaturations.  Perhaps I should delete the information about the smaller study, since the larger study had the same conclusion.206.59.61.72 23:12, 16 February 2006 (UTC)


 * I focused on featured articles, in the biology and medicine section, as they have been subjected to medical review. Asthma includes a paragraph on alternative medicine, and although I don't know all the terminology, it appears to have one sentence on each "alternative", summarizing the actual medical research supporting (or not) the treatment.  Multiple sclerosis includes a section called "Therapies under investigation", which includes between 1 and 3 sentences on each therapy that is the active subject of current research (not our case).  Pneumonia, Prostate cancer and Tuberculosis do not seem to include experimental treatments or treatments in development.  I know the MCotW is currently working on AIDS, so I went to see what's there, although it is not yet a featured article.  It has one sentence summarizing current research, and a section summarizing the usefulness and research regarding alternative medicine. The other medical articles seem to support a brief summary of experimental or in research treatment modalities, but not lengthy discussions of each.  Sandy 23:21, 16 February 2006 (UTC)


 * Let's see the article on glaucoma has a very long paragraph about marijuana treatment. Much longer than the Marinol paragraph.  206.59.61.72 23:23, 16 February 2006 (UTC)
 * I note that the glaucoma article has a very light edit history, possibly reflecting low editor participation and limited to no (?) medical review. I can't judge the accuracy or relevancy of what is there. Sandy 23:28, 16 February 2006 (UTC)


 * The Multiple sclerosis article had this to say:"MS patients who use Cannabis report a soothing of the painful muscle spasms and improved muscle coordination. Some are able to walk unaided when they were previously unable to do so. It also helps blurred vision, tremors, loss of bladder control, insomnia and depression." So in fact our mediator was wrong when he said there was only one sentence in the MS article on cannibus!  You can't explain away everything.206.59.61.72 23:34, 16 February 2006 (UTC)
 * I noticed that the rest of the MS article is cited and referenced, but those 3 sentences are not. We might check the edit history to see if they were added after medical review?  I didn't find references for those entries in the References section, but I did find a website about cannabis that was added to External Links.  Sandy 23:50, 16 February 2006 (UTC)


 * It seems to me that the article on Parkinson's Disease does address quite a very alternative and experimental treatments, including stem cells, etc. It does not have a subjection for experiment treatments, it is all just in one very long section on treatment.206.59.61.72 23:41, 16 February 2006 (UTC)


 * In fact I have found no precident for the "disclaimer" sentence that the Marinol paragraph has at all! Deleting it would make it more breif.206.59.61.72 23:45, 16 February 2006 (UTC)


 * Now the paragraph is just 3 sentences. Sandy did say that all Marinol deserves is two or three sentences.206.59.61.72 23:48, 16 February 2006 (UTC)


 * To be accurate, the two or three would need to reflect the safety concerns raised in RxList. Sandy
 * Schizophrenia is/was a featured article. It has a long section on cannabis, but as a potential causative factor in the condition.  Under treatment, it discusses dietary supplements with a paragraph (3 sentences).  It has an entire section on alternative approaches, but that paragraph addresses views of schizophrenia, rather than treatment.  In summary, I haven't found a medical article that devotes more than a sentence or three to experimental treatments, but if we were to get Marinol down to 3 sentences, the safety issues raised in RxList should be mentioned as to why it is not likely to become a widespread treatment for the *majority* of patients with TS, who are children, since the prevalance of tics is higher in children than adults, as it is a condition (unlike schizophrenia) which tends to remit with maturity.  Sandy 00:07, 17 February 2006 (UTC)
 * Sandy the RX list is just the package inserts. All package inserts on stimulants tell people  not to use the stimulants with TS.  Should we put that in the article?  As you know, the package inserts made by companies list as many things as possible, even things that are not proven, for liabity purposes.  We should include the rxlist information on the stimulants if we are going to include RX list information on marinol.  Now as far as the article on schizophrenia, if that article had stuff on how marijuana makes schizophernia worse, fine.  But there is NO evidence of Marinol making TS worse!  Also, any speculation on how likely Marinol treatment is to become widespread amongst children or adults in the future is pure POV speculation and does not belong in this article!  You don't have a crystal ball!  Now there are just 2 sentences on Marinol anyway!206.59.61.72 00:15, 17 February 2006 (UTC)
 * Also, all the rxlist information about all of the neuroleptic drugs show much worse side effects than anything the rxlist says about Marinol! Haldol is used on children all the time!  Marinol is a lot safer than Haldol.206.59.61.72 00:18, 17 February 2006 (UTC)
 * I think you've done a fine job on what you've done with it. But, not everyone knows what THC is, and Marinol is a more common name than dronabinol, which redirects to TSH on Wikipedia anyway.  Would this work for you??


 * Controlled research on treating Tourette's with tetrahydrocannabinol, a synthetic version of the main psychoactive substance found in cannabis (brand name Marinol®), showed the patients taking Marinol® had a significant reduction in tic severity without serious adverse effects, and more significant reduction in tic severity was reported with longer treatment. The researchers reported a trend towards improvement in cognitive functioning in patients taking Marinol, before and after treatment. Sandy 00:41, 17 February 2006 (UTC)
 * That seems alright, but I just made the letter THC into a link. That would be shorter than tetrahydrocannabinol and still links to the same article.
 * Well I removed the link to drabinol, but someone else put it back up. So I guess it will stay.  Unfortunatly, THC stands for too many articles.206.59.61.72 04:39, 17 February 2006 (UTC)
 * Oh I think I see what you want. Okay I just added that THC is the main psychoactive chemical in cannibus.206.59.61.72 04:49, 17 February 2006 (UTC)
 * I edited the article a little more. Now the last two sentences read "In controlled studies on treating TS with Dronabinol, a synthetic version of Tetrahydrocannabinol, the main psychoactive chemical in cannibus (brand name Marinol®), researchers reported that Marinol® had a significant reduction in tic severity without serious adverse effects, and more significant reduction in tic severity was reported with longer treatment.[51] The researchers reported a trend towards improvement in cognitive functioning in the people with TS taking Marinol, before and after treatment.[52]"  Is that okay with you?206.59.61.72 04:55, 17 February 2006 (UTC)
 * Thanks for working together on this, Anon. I just juggled the words a bit, moving the Marinol phrase up in the sentence.  I think generic names are not capitalized ? It looks like a nice entry now.  Quite a while back, I added your longer wording to the marijuana and Marinol pages, so you might want to keep an eye on those pages.  (I also added deep brain stimulation to its page.)
 * I was hoping that Francis now could give us some direction in figuring out how to handle some of the other recurring things that come up on the Tourette entry? Perhaps we could talk about how to handle External Links next ?  Sandy 14:01, 17 February 2006 (UTC)

Anon, I left a message for you on your talk page about a copyright question. User_talk:206.59.61.72 Maybe we can talk about that question on your talk page ? Sandy 14:35, 17 February 2006 (UTC)

Another Photo, copywrite issues
Well, according to wikipedia, anything in which the author had been dead for more than 100 years (or any photograph of something like that) is in public domain. I have uploaded another image of Dr. Tourette. This is a photograph, and we can assume that Dr. Tourette is the "author" because he probably paid the photographer to take his picture, and it is impossible to know the name of the photographer. Besides, the photographer is not necessarly the "author" just as the person who does the camera work on a movie is not necessarly the director. It also said anything published before 1923 in the US is public domain. I think that considering Dr. Tourette died 102 years ago, all these images are in public domain. But maybe we should use this photograph I just uploaded, because it is not a drawing. Frankly, I don't think they had copywrite laws in France back then, but we are pretty safe with this photo.Btar 18:34, 17 February 2006 (UTC)


 * Btar, thanks for investigating the copyright issue and uploading the pictures. So, it sounds like we're in the clear in either case?  Maybe we could use one picture on the TS article, and the other picture on the article about 'ole Brutus himself, allowing us to use both of your pictures?  The current picture "fits well" on the page, so maybe you can add that one to the article about GTS?  Sandy 18:40, 17 February 2006 (UTC)
 * Yeah, it occured to me that the drawing would qualify as a photo of something who's author died more than 100 years ago. I will look into the GTS article.Btar 22:43, 17 February 2006 (UTC)
 * Btar, nice work! I'm so glad you have an account now.  I left a comment on your old talk page, that I will move to your new talk page, here.  Can you let us know when you've had a chance to look at the External Link question (above)?  Sandy 22:57, 17 February 2006 (UTC)

Extensive content reversion
 Ghostsandempties, I concur with you that Aykroyd was likely joking, but others have disagreed in the past -- some people actually believe the rumor, so giving the summary of the issue in NPOV helps the reader decide. You also deleted the clarification about the Mozart rumor, which was fueled by Wikipedia entries and is now well established on the internet, and the context of sociological and cultural issues, which was set up to lend itself to future improvements in the article. These items have been discussed with other editors. How about bringing such large content deletions to the talk page, to develop consensus for improving the article?

Also, your addition of the inaccurate profanity, "A musical about Tourette's, In My #*$@! Life," looks like vandalism, as the name of the musical was "In My Life." Sandy 02:46, 7 April 2006 (UTC)
 * As was, the presentation wasn't so much NPOV as it was presenting and disproving controversies over these two. Just cut to the chase rather than bloat the article, which is already past it's recommended length. In Mozart's case, the references are an excellent way of presenting opposing viewpoints. In Akroyd's case, all we have is the radio interview. Other websites are based on the same tape.  It's not worth sacrificing clarity for the purpose of squelching false rumors.  If you want, you can add "He was just joking about the Aspergers!"Ghosts&amp;empties 07:49, 23 April 2006 (UTC)
 * It would not be correct to stay that, in Aykroyd's case, all we have is the interview. Every statement in the content you deleted was or can be referenced and substantiated (I will work on finding those references which were missing; for example, the commonly known fact that Asperger's did not exist as a diagnosis when Aykroyd was a preteen, an important verifiable fact which your edits deleted). Your suggestion to just add "he was joking" cannot be referenced or verified, and would be POV, since even the interviewer indicated that she couldn't tell if he was joking (direct quote from the audio tape of the interview, mentioned in the content which you deleted).  Your reformatting has also included Aykroyd in a long list of people known to have Tourette's, although his diagnosis is speculative at best.  Controversy and speculation sections are included in other Wiki medical articles (e.g.; Asperger syndrome).  This entry was discussed with two other editors, and concurrence reached on how to present the interview content vis-a-vis the accuracy and verifiability of the diagnoses he may have been joking about.  Also, please refrain from editing comments from others on talk pages, as this is considered vandalism.  Here is the talk page before | you edited my talk entry, and |your edits.  Please do not remove my time-stamped signatures, or alter the formatting of my entries.  I'm glad to see you are starting to add edit summaries to some of your entries.  It would be helpful if you would use them regularly.  Sandy 12:37, 23 April 2006 (UTC)
 * The discussion on how to present Akroyd's TS were on his article's discussion page, which I didn't see till after I edited this one. Not that the discussion there really changed my mind, but I can definitely see how it's frustrating stomping out rumors like the Mozart one. I'm probably as stuborn as you, but not as fast a typist so I concede.
 * My basic approach is to write for a reasonable reader. Any reasonable reader who had read the cited facts you present would end up come to the same conclusions that you have - Mozart probably didn't have TS, as well as can be diagnosed centuries later, and Akroyd almost certainly doesn't have Asperger's. (Terri Gross didn't have the smoking gun about the Asperger's discovery or its personality profile). Mixing Aspergers and TS is confusing for the uninitiated reader. Unfortunately many people have heard that Mozart had TS, but 99% haven't.  No one can prove that Mozart didn't have TS.  But as an editor you can conclude based on evidence that the speculation is so weak as to be unworthy of a *short article*.  It's probably true that if you don't mention Akroyd's soi disant Asperger's, somebody will add it in every few weeks, but that's what editors are for.  Meanwhile, the honest folk with a sincere desire to learn about a much misunderstood malady will have an article they can read in one sitting.
 * Thanks for the compliments about my edits. I'm particularly proud of Love sickness.  I'd say check it out, but you probably already have. Ghosts&amp;empties 17:55, 24 April 2006 (UTC)

Length
Colonel Marksman 04:02, 25 April 2006 (UTC)
 * Kudos for the numerous references on every single pargraph and NPOV'ing! This is a rare sight for the articles I frequently visit.
 * The article does seem very long. It's over 6,000 words excluding references and external links. The article also focuses a lot on tics specifically as well. When I first started my search on Wikipedia, I was disappointed at the short length of the tic page, but now I know why it is so short: everything is in this article.
 * Although major revisements is not advised, all I suggest is a re-evaluation of this article, and a separation of specifically, "tics" from "Tourette syndrome" page. IOW, yes tics are important part of the Tourette syndrome, but the extension to their reference is very frequent in this page.
 * Instead of cramping all the information as possible into this article, is it possible to space it out a litte? (E.g. "Treatment of Tics" could go into the tic article, with a reference to it from this article).
 * If the tic disorders in the Tourette syndrome are really that specific, try breaking this article up into perhaps a few more (e.g. a page with Tourette syndrome in relation to other disorders in a separate page would really break things into an easier read).
 * The article also seems to "repeat" itself, stating some of the same information over again without a great amount of notice.
 * Don't take my total word and follow my every suggestion, as I am not an expert, but let's not discourage the reading of this article.

(Will delete this last add as soon as someone contacts me) -- Does anyone know anyone I can contact about my tic disorders? E-mail me at colmarksman@msn.com if you do! Colonel Marksman 04:04, 25 April 2006 (UTC)


 * Hi, Colonel! Thanks for the helpful comments.


 * With respect to your last comment, just google Tourette Syndrome Message Board and you'll find helpful options.


 * There have been lots of helpful suggestions as to how to lower the length of the article, but I've been waiting for a few other editors to be available (you might want to review those comments and ideas on my talk page). I do agree with you that moving a lot of the tic descriptions, definitions, differential diagnosis info to the tic article would help shorten this article:  if you concur, I can work on that ?  I'm not completely sure, though what you mean by, "The article also focuses a lot on tics specifically as well."  Tourette's is a disorder of tics, so I'm not really clear how it could not focus on tics?  Can you give me a few specific examples of what you're referring to, or is it just a matter of moving some of the tic info to the tic article?  (When I started on the TS article, the tic article was barely more than a stub:  now we have more to work with.)


 * I'm not sure how to work your idea of putting treatment of tics into the tic article, since transient and chronic tics rarely require the treatment options that TS requires ?


 * What would really help shorten the article would be to implement some of the ideas you can find on my talk page -- let me know what you think ? In particular, we could shorten the experimental treatments section, and the stuff which is currently labeled as sociological/cultural, by implementing Encephalon's suggestions.  The mention of every single movie and person with TS is just so unnecessary.  I haven't wanted to move forward without more consensus.


 * You said, "e.g. a page with Tourette syndrome in relation to other disorders in a separate page would really break things into an easier read". I'm not following that suggestion -- can you explain better or give an example?


 * Can you also give some examples of information that is repeated, so we can work on it?


 * Glad to see you here -- some help and consensus is welcomed, and was needed! I got stalled with a lot going on in real life, but you can find my To Do List here and my talk page here.  As you'll see, I was having a hard time shortening the article when I first started editing, as I encountered resistance from fellow editors.  :-)  In particular, I encountered strenuous resistance for several months, when trying to shorten the vanity entries, external links, and the entire paragraph about Marinol/marijuana.  If there is now concurrence, I'd be happy to "take some editing shears" to those parts of the article. Sandy 12:55, 25 April 2006 (UTC)


 * Sandy, this is a beautiful article. *Cries!* Cheers to anyone who contributed to this one! Although the editing says that ariticle is too long, this is all still core, necessary information and it does have sub-pages. I hence remove any concerns over the length.
 * However, this is not so with all pages. Adolf Hitler is grieviously and painstakingly terrible. It's problem is not length, but the contributing factor--details, details, details! The section on Hitler's childhood is longer than the section about his involvement in WW2. The explosive Wikiwar over Hitler's religion and neutrality of the article is destroying it. It's more about detailed and tiny information that is really unnecessary than what is important.
 * Peace be blessed here! Colonel Marksman 19:43, 18 May 2006 (UTC)


 * Glad you're pleased with it, but I still feel I have more work to do to incorporate your earlier concerns. I just need a large block of free time so that I can really focus on your suggestions, and it hasn't appeared yet :-)  I have seen some horrificly way too long articles (100KB), that are impossibly slow to edit because of their length, so I agree our current length is optimum, and hope we can strive to keep it there.  Sandy 23:24, 18 May 2006 (UTC)

Famous People
I suffer from Tourette’s syndrome, and was wondering if any one would like to start a 'famous people' list of fellow suffers? It might be something of interest for those that have more then mild TS, to see what people in history have achieved with the disorder. I would put my self on the list because I am the CEO of a multi million dollar business, but other people like sports stars, and military veterans might also help, seeing both require high control of the tic's. --Amckern 16:17, 22 May 2006 (UTC)
 * A discussion/list of recognized persons with Tourette syndrome can be found at Sociological and cultural aspects of Tourette syndrome. I've tried to avoid using the term "sufferers" as that expresses POV.  People being added to the list should fulfill the notability criterion for Wiki. Sandy 01:27, 23 May 2006 (UTC)

coprographia?
I've read elsewhere that a few TS people experience coprographia. Is this worth addressing? Ghosts&amp;empties 02:54, 24 May 2006 (UTC)
 * If you have a reliable source. I've never seen one.  Sandy 03:27, 24 May 2006 (UTC)

Miracle Cures?
I have TS people and my friends often tell me about something that was said on TV shows on TS. Recently, there has been a lot of stuff in the media about miracle cures for TS involving brain surgury. This procedure seems to be quite risky and I don't really think 99.9% of the cases of TS are bad enough to warrent brain surgury, even if this was a procedure that is eventually approved by the FDA for TS.

Montel Williams recently had a "miracle cure," and that is what people want to see, but the thing I dislike about all this is that it makes TS look like something that you need brain surgury for. TS is not like Parkinson's, which is degeranative and fatal.

I think something should be said about this procedure, in case people see it on TV and decide too look it up. I don't think this will be giving too much publicity to this, because it has gotten plenty of publicity.

This is an encycylopedia article and we should assume that the peopke reading this article are mostly intelligent laymen, not doctors. This is not the PDR. I think we should briefly explain to the intelligent layment what the procedure is first of all. Is this "miracle cure" the same thing as P.A.N.D.A.S. or deep brain stimulation? Because I don't really what those two things are. So I think it would be a good idea to briefly explain what this procedure is that keeps getting all the news attention, WHY it is dangerous and is unlikely to become widespread, and most importantly, why most cases of TS should never need such a drastic treatment as surgery of the brain. Karmak


 * What "miracle cure" procedure are you referring to? P.A.N.D.A.S. is explained on Wikipedia and is not a procedure or a cure, and has nothing to do with Deep brain stimulation, which is also explained on Wikipedia and linked to from the Treatment of Tourette syndrome article, which also discusses deep brain stimulation.  If you are still confused, you might peruse this information on deep brain stimulation for Tourette's, to help explain what else you think should be addressed in the Treatment of Tourette syndrome article.  Sandy 19:20, 30 May 2006 (UTC)

Semi-automated suggestions
The following suggestions were generated by a semi-automatic javascript program, and may or may not be accurate for the article in question. You may wish to browse through User:AndyZ/Suggestions (and the javascript checklist; see the last paragraph in the lead) for further ideas. Thanks, Andy t 21:27, 3 July 2006 (UTC)
 * Per WP:CONTEXT and WP:MOSDATE, months and days of the week generally should not be linked. Years, decades, and centuries can be linked if they provide context for the article.
 * Per WP:MOSNUM, there should be a non-breaking space -  between a number and the unit of measurement. For example, instead of 18mm, use 18 mm, which when you are editing the page, should look like: 18&amp;nbsp;mm.
 * Please reorder/rename the last few sections to follow guidelines at WP:GTL.
 * Please alphabetize the interlanguage links.
 * article may need to undergo summary style, where a series of appropriate subpages are used. For example, if the article is United States, than an appropriate subpage would be History of the United States, such that a summary of the subpage exists on the mother article, while the subpage goes into more detail.
 * There are a few occurrences of weasel words in this article- please observe WP:AWT. Certain phrases should specify exactly who supports, considers, believes, etc., such a view.
 * Watch for redundancies that make the article too wordy instead of being crisp and concise. (You may wish to try Tony1's redundancy exercises.)
 * Vague terms of size often are unnecessary and redundant - “some”, “a variety/number/majority of”, “several”, “a few”, “many”, “any”, and “all”. For example, “ All pigs are pink, so we thought of a number of ways to turn them green.”
 * As is done in WP:FOOTNOTE, for footnotes, the footnote should be located right after the punctuation mark, such that there is no space inbetween. For example, change blah blah [2]. to blah blah.[2]
 * Please ensure that the article has gone through a thorough copyediting so that the it exemplifies some of Wikipedia's best work. See also User:Tony1/How to satisfy Criterion 2a.


 * I’ve checked and corrected some of these things. However, my methods were semi-automated, too, so I cannot, in particular, guarantee the one about units of measurement. (I simply couldn’t find any.) I’m going to have to leave the rest to people who actually have a clue about the matter, though. —xyzzyn 22:18, 3 July 2006 (UTC)

Eponymous DISEASES
Why add Tourette and Asperger's to a DISEASE category when people agree it is not a disease? Could we have some consistence, please? --Rdos 14:03, 7 July 2006 (UTC)
 * The point of the category is not that it is a "disease", rather that it's an eponym. I agree with your objection to the word "disease", but disagree with your methods, which amount to disrupting Wikipedia to make a point, when you've not attempted to correct the underlying problem.  If it bothers you so much that the category is misnamed, you should go through the work of getting the category renamed to Eponymous conditions or Eponymous medical conditions.  You can do that on Categories for discussion.  Put in the nomination, and I'll support it. Unless you're willing to do that work, please don't disrupt Wiki just to make a point.  Sandy 14:24, 7 July 2006 (UTC)
 * Never mind, I did the work myself. Added the articles to the Eponymous medical terms category.  Sandy 14:42, 7 July 2006 (UTC)

Image
http://www.cdc.gov/ncbddd/tourette/default.htm

Public domain? Can anyone help me figure out if there are copyright issues, and figure out how to load it up to Wiki ? Sandy 06:18, 10 July 2006 (UTC)


 * As far as I can tell, the NCBDDD is part of the US government and the page, including the image, is work of the NCBDDD. Therefore you should be able to use the image here per WP:C.
 * Download it to your computer and go to Special:Upload. Give the path to the file on your computer as the source and a name for the uploaded file on Wikipedia. (Beware: there’s a typo in the original filename, so if the javascript which automatically generates a destination name works, check what it does, anyway.) Put  and the URL of the page in the summary. Click on ‘Upload file’. That is all. —xyzzyn 07:08, 10 July 2006 (UTC)


 * Umm... actually, can someone explain to me why this image is noteworthy?  Nothing can be learned about Tourette syndrome from looking at a still image of a Tourette sufferer.  Kasreyn 22:36, 6 September 2006 (UTC)


 * Tourette's occurs in a range of people just like the non-Tourette's population. A collage of young, old, male, female, various races, is what Tourette's looks like.  I will work on the caption to make that point more clear.  Sandy 22:43, 11 September 2006 (UTC)


 * What would be far more useful to this article would be an audio recording of a Tourette sufferer's vocal tic. Kasreyn 20:46, 9 September 2006 (UTC)


 * Not all persons with Tourette's are "sufferers" and most do not have audibly notable vocal tics. Common vocal tics are gulping, coughing, throat clearing, sniffing, and other ordinary every day commonplace noises, which wouldn't make for a very interesting audio clip.  The rare tics that you might be thinking of would inaccurately sensationalize the condition, as they are so uncommon.  The common place vocal tics are shown on the video clips already included in external links.  Sandy 22:43, 11 September 2006 (UTC)

Pardon?
You know, I've read the page for Tourette's syndrome and I'm still none the wiser. Perhaps someone who knows the subject well could explain (in English) exactly what a Tourette's syndrome sufferer suffers from. Many thanks. —Preceding unsigned comment added by 172.213.161.145 (talk • contribs) 15:05 27 August 2006 UTC AOL.

Indeed
Why not a label for Tourette syndrom Wikipedians? Im sure there are more than a few "Shackey Jakes" out there who can explain whats up. —Preceding unsigned comment added by 152.163.100.13 (talk • contribs) 23:32 29 August 2006 UTC AOL.

GA pass
I went through this and made some changes. I removed the sentence "Probabilistic models may yield better results in finding the cause, as the autosomal dominant inheritance model has not been validated." since even as a biochemist I'm unclear as to what this means. Otherwise, an excellent and thorough article. TimVickers 20:37, 31 August 2006 (UTC)

Images
The second image (the one that is a totally naff collage of pics) should not be on there, it looks totally unprofessional and like a 5 year old did it in paint! Rob.derosa 04:15, 6 September 2006 (UTC)


 * I'm sorry it doesn't please your artistic sensibilities: if you are able to locate a better contemporary image, that would be stupendous.  Since all of the other images are largely of centuries-old dead people, the article somehow needs to convey that Tourette's is a common condition among people that are young, old, male, female, of all races, and just like everyone else.  If you can find another image the conveys the contemporary reality of TS, it would be great.  Sandy 22:31, 11 September 2006 (UTC)

License issues
The last two are major issues that should be a priority to fix before a WP:FAC nomination. Jkelly 15:35, 11 September 2006 (UTC)
 * Image:Gilles tourette2.gif could use better sourcing (where was this published?), but is probably fine
 * Image:Tim howard.jpg needs to be removed from the article, for failing Fair use criteria
 * Image:Malraux.jpg is in danger of deletion for having no source
 * Thanks, JK. I saw you removed Howard, and I removed Malraux.  Sandy 22:18, 11 September 2006 (UTC)

The collage & legend
I disagree with User:Wouterstomp that this photo combined with the legend beneath the photo, should be removed on the grounds that it "doesn't add anything to the article". I say that it is a humanizing touch to a condition that is confusing and baffling, little understood. Given that the US Dept of Health and Human services commissioned it to help defray fear and prejudice directed at those who have Tourette's. As Sandy pointed out, otherwise there are only moldy old photos of chaps in powdered wigs hundreds of years ago. And a cartoon brain to make a visual break in a long page, but which does not add at all to the understanding of how the brain is involved. So unless someone comes up with something better, I say it stays. After all, I have Tourette's and I happen to think the picture should be exactly where it is. Talk it out here, don't just delete it. 205.188.117.73 09:31, 17 September 2006 (UTC)


 * Although you might find it humanizing, this image is so aspecific that it could be just as well on any other disease article. The text in the caption could easily be incorporated in the article, but I personally don't think that image has much purpose here. --WS 10:46, 17 September 2006 (UTC)


 * I'm not going to fret over one image, after spending eight months working on text and references: in the long run, whether the image is included or not doesn't make a big difference.  Sandy 14:15, 17 September 2006 (UTC)


 * I see the image was restored: it's silly to edit war over an image.  Three want it (myself, AOL anon, and xyzzy_n), three don't (Kasreyn, Rob.derosa and Wouterstomp):  please don't reinsert the image without a discussion on talk page to reach consensus.  Sandy 15:23, 17 September 2006 (UTC)  (Noting that Anon and I feel the same about the cartoon brain, which oversimplifies all involved in TS, but what are we gonna do :-)  Not worth worrying about ... I'm more concerned about the text being accurate.  :-)  Sandy 19:14, 17 September 2006 (UTC)


 * On the other hand, I am going to fret over the short, stubby paragraphs introduced into the writing, which has already passed several good copy edits, by the anon AOL editor, as well as the extra spaces introduced between sections. Stubby paragraphs are always an objection on FAC.  Also, since Tony is in the midst of a thorough copy edit, including the insertion of inline comments and questions, it would be helpful if other editors would let him finish. Sandy 14:44, 17 September 2006 (UTC)


 * The chopped paragraphs resulted in unreferenced and incorrectly referenced text: I've now repaired it.  Sandy 16:05, 17 September 2006 (UTC)

My Tourettes
I have a very debilitating manifestation of Tourettes that makes it virtually impossible for me to leave the house - due to the strong taboo attatched to my main verbal tic, which is to let out a shout of the n-word (particularly when I get anxious or stressed). Due to this being an extremely taboo racial slur I feel unable to risk causing the kind of offense that I would by going out, particularly when I could come across black people in daily life. Does anyone else have a particularly bad manifestation that makes a social life almost impossible? I read about a poor man whose tic was related to child-rape - even worse than my own, probably. The problem is that the more taboo a word or phrase is, and the earlier you pick it up, the more it feeds into the Tourettes. I hope there is one day a cure because my life is miserable. 195.93.21.129

Your life is miserable due to the non-awarness of this in public. But how but you yourself take measures. Print yourself some white shirts with a significant message on the front and back, like "tourette! sorry for the cursing". At the least you get peoples neuro circuits fired up in that they are contradicted with new experience - and start to ponder instead of immediatly categorizing you as insane, because you their brain tells them it is routine just look away, avoid, ignore. The medication out there works for some to curb the symtpoms but only to about 50% but that is already a huge step forward. And go see some psychotherapy because it is not worth wasting your life for that. Frankly however there are situations where i couldn`t tolerate verbal tics namely during lectures etc, so it is an enormous burden for anyone - but i think ....on the street, who cares. It provides some diversity. Don`t hold back but be aware that in some situations you gotta realize you have to take measures yourself. E.g. you could gag yourself if you attend a lecture or something like that. You`ll see humans are quite tolerant and caring once they realize who you are. Slicky 16:23, 11 September 2006 (UTC)

New review
I have some suggestions: Anyway, a perfectly referenced, well-written article which, in my opinion, should be FAC. NCurse work 06:45, 17 September 2006 (UTC)
 * "However, this symptom is present in fewer than 15% of people with TS" (a reference would be useful)
 * The reference is in the body, not in the heading, which is only a summary of the text in the body. Do you want references in the heading as well, even though they are given in the body?  Sandy 14:26, 17 September 2006 (UTC)
 * Added references to lead. Sandy 15:24, 17 September 2006 (UTC)
 * in section Causes, altering expressivity or penetraion should be mentioned Added back. Sandy 16:16, 17 September 2006 (UTC)
 * It is mentioned, but another medical reviewer (who may not have understood variable penetrance) watered it down. It currently says:
 * A person with Tourette syndrome has about a 50% chance of passing the gene(s) to one of his/her children. Not everyone who inherits the genetic vulnerability will show symptoms: even close family members may show different levels of symptom severity. The gene(s) may express as Tourette syndrome, as a milder tic disorder (transient or chronic tics), or as obsessive compulsive symptoms with no tics at all. Only a minority of the children who inherit the gene(s) will have symptoms severe enough to require medical attention.[6]
 * Can you explain better what you want me to add: a specific mention of variable penetrance and alternate expression?  Sandy 14:26, 17 September 2006 (UTC)
 * Added back mention of variable penetrance, which had been deleted by an earlier editor. Sandy 16:09, 17 September 2006 (UTC)
 * Seems to be perfect for me. NCurse work 16:27, 17 September 2006 (UTC)
 * maybe I've missed some discussions but why Management is not Therapy?
 * Not clear what you're asking. Manual of Style (Medicine-related articles) calls for Treatment/Management.  I dropped treatment because not all persons require treatment, but management of TS, for severe cases, goes beyond therapy, so I'm not understanding your point.  Sandy 14:26, 17 September 2006 (UTC)
 * in section Prognosis, "One study showed no correlation with tic severity and the onset of puberty, in contrast to the popular belief that tics increase at puberty." sentence should have a reference Fixed: this happened because a previous editor chopped the paragraph in half, leaving it unreferenced.  Sandy 16:17, 17 September 2006 (UTC)
 * The reference is given for the entire section (a couple of sentences): I'll repeat it.  Sandy 14:26, 17 September 2006 (UTC)
 * I see what happened here: before you read the article, another editor chopped the paragraphs in half, separating statements based on one source, and leaving that paragraph with no source and resulting in stubby paragraphs.  (That happened throughout, without regard to referenced paragraphs.)  I've re-combined now.  See if it's well enough referenced for you, or if I should repeat the refs.  Sandy 15:55, 17 September 2006 (UTC)
 * the Topics related to Tourette syndrome template couldn't get a nice table? It's not so important. NCurse work 16:27, 17 September 2006 (UTC)
 * Someone switched it to a table once, and it was awful and visually confusing, so I switched it back. Why do you prefer a table?  Sandy 14:26, 17 September 2006 (UTC)
 * maybe more external links?
 * Nope. That was the subject of a mediation, because every Tom, Dick and Harry wants their link included, and the article was a link farm; User:FrancisTyers came up with a brilliant solution.  The DMOZ link includes every decent TS link already, and we're not supposed to repeat links which are already included in References, where we already have every important article on TS.  See WP:NOT and WP:EL.  Sandy 14:26, 17 September 2006 (UTC)


 * Thanks Sandy 14:26, 17 September 2006 (UTC)


 * Thanks for the answers! What about FAC? :) NCurse work 16:27, 17 September 2006 (UTC)


 * Will consider it when editing settles down, and when I don't have pending travel: for now, we seem to have some disagreement over one image, and I need for Tony to complete his ce in peace :-)  Sandy 16:29, 17 September 2006 (UTC)

In use
I will take the article temporarily out of use this morning, to address the issues above. I will look at Tony's inline comments, review the additions needed from NCurse's comments, and repair the short, stubby paragraphs introduced by the anon AOL editor. Then, it would be helpful if other editors would suggest changes on the talk page, until Tony is done with the copy edit, so we don't get crossed up. Thanks, Sandy 14:48, 17 September 2006 (UTC)


 * Done: it would be really really helpful if others would let Tony complete his copyedit before making other changes, which we can hopefully discuss on talk page.  Thanks!  Sandy 16:11, 17 September 2006 (UTC)