Pamela Schuller once had the worst case of Tourette's syndrome in the United States.

As a teenager, she suffered from involuntary movements so severe that she once broke her neck.

She would make animal noises and swear uncontrollably.

Now 29, and living in New York, the American Jewish comedian is making a name for herself by talking about her experiences on stage at events across the globe.

Tourette's is a neurological condition affecting the brain and nervous system, characterised by a combination of involuntary noises and movements.

The condition affected Ms Schuller's self-confidence.

"I believed that I was a waste of space. I couldn't describe anything good about myself," she told a 70-strong audience at the Limmud conference this week.

But attending an arts school in Vermont and Jewish summer camp gave an idea of how she might cope.

"At the school, I was signed up to a comedy and improv class. I started to diffuse my Tourette's with humour."

The experience allowed her to start a career as a stand-up.

She also campaigns for methods of inclusion to encourage people with disabilities to take part in society - and works with the Union of Reform Judaism and Stand-Up Inclusion.

She said: "For most of my life, 'inclusion' felt like a bad word. To me, it meant that people had to accommodate me. When not used correctly, it can be a term of separation."

She said that at one stage, the Jewish community lacked understanding of her condition.

She recalled: "When my dad died, the Jewish community rallied around my family in support.

"But when my Tourette's became so bad that I became depressed and disruptive, the Jewish community did not know what to do - so they didn't do anything."

She continued: "We have a long way to go. We live in a world that does not accommodate difference."

She said the hardest part of being a her job as a comedian was being a woman - not suffering with Tourette's.