LEROY, NY - The New Jersey neurologist who examined eight students from Le Roy with the strange Tourette-like symptoms announced he found evidence they could be suffering from Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, or PANS or PANDAS.
He says he is not working with Dr. Laszlo Mechtler of Dent Neurologic Institute who has diagnosed most of the 18 students affected with Conversion Disorder, a psychological illness.
Dr. Rosario Trifiletti's statement in full:
LE ROY, NY TEENS: BEHAVIORS LINKED TO INFECTIONS
Ramsey, NJ - February 6, 2012 - Rosario Trifiletti, MD has announced the results of the laboratory data that he collected in standardized fashion from eight of nine girls he examined in Le Roy, NY. National attention has been drawn to the plight of the teens who havebeen unable to control various bodily twitching and jerking movements. Dr. Trifiletti reportedthat five of eight girls show evidence of Streptococcus Pyogenes (common Group A strep) and seven of eight show evidence of infection with Mycoplasma Pneumonia (the bacteria that causes walking pneumonia). All eight girls tested show evidence of infection with at least one of those pathogens. Both of these bacterium have been associated with a PANDAS-like illness of sudden onset of motor and vocal tics. "A PANDAS-like illness is my working diagnosis, rather than a mass conversion disorder as others have suggested," said Dr. Trifiletti. He has already started treating the girls with antibiotics and anti-inflammatory agents. When asked to comment on the continued insistence by Dr. Laszlo Mechtler that the girls have conversion disorder (or mass hysteria as Dr. Mechtler originally stated), Dr. Trifiletti said, "I'm confused by that because he's never actually seen or interviewed any of the nine girls I examined."
These findings provide a significant clue in the Le Roy High School mystery, but certainly many questions remain. Streptococcus Pyogenes and Mycoplasma Pneumonia arecommon pathogens that children throughout the world are exposed to every day. Why this town? Why this particular child and not another? Why such a curious presentation resembling Tourette syndrome? Until these questions are fully answered, the doctor said that the cluster will remain a mystery. "I suspect that genetic, environmental factors provide an immune background where the PANDAS-like response is possible to common pathogens. The infectious exposure is simply 'the straw that broke the camel's back,'" said Trifiletti. However, the infectious exposure points the way to rational medical treatment for these children, which he said is of immediate importance. "Clearly, their response to the treatment I've started will be helpful in supporting my working diagnosis," he added.
As with most illnesses, Trifiletti said there is a complex interplay of genetic and environmental factors involved. As with all illnesses, psychological factors possibly play some role as well. "All we have done here is provided evidence for exposure to two infectious agents as potential factors," said Trifiletti. "I encourage efforts to further explore genetic and other environmental factors that likely are playing an additional role here."