ABSTRACT
CASE PRESENTATION The patient is a 59-year-old man with a history of facial twitches, throat clearing noises, and grunting sounds that began at age 4 years. As the symptoms evolved he exhibited frequent grimacing, jerking of the head, and twirling when walking. Snorting, barking, and throat clearing worsened gradually to become at times loud noises, short phrases, and, occasionally, foul language (coprolalia) (see video, Case 83 ). In spite of this, was able to work, marry, and raise a family.
