ABSTRACT
In 1980, Bliss (1) provided one of the first reports emphasizing the significance of sensory phenomena in Tourette’s syndrome (TS) through an introspective analysis of his own personal experience with the disorder. After years of careful observation, he became aware of sensory signals preceding movements. ‘‘Each movement is preceded by certain preliminary sensory signals and is in turn followed by sensory impressions at the end of the action. Each movement is a voluntary capitulation to a demanding and restless urge accompanied by an extraordinarily subtle sensation that provokes and fuels the urge.’’ ‘‘The intention is to relieve the sensation, as surely as themovement to scratch an itch is to relieve the itch.’’ Based on this experience, Bliss emphasized that ‘‘the movement is not the whole message.’’ ‘‘The movement, even if grotesque andmiserable, is not the most important part of TS activity. Clinical evaluations have centered on the overt symptoms, but curiously they have stopped short of probing for the sensory events, the covert modes, that show before and at the end of the evident act. The sensory symptoms are there, and they tell more than the visible and audible actions.’’
