> recent entries
> calendar
> friends
> profile

Saturday, December 26th, 2009

doc_neuro

4:44p More evidence my decision to finish up premed and go to med school is correct About a month ago Tristan posted this article about a girl with intractable sneezes (12,000 a day roughly) that was baffling doctors. I noticed right away the tic like nature of it and suggested it was a tic disorder related to Tourette Syndrome. They clearly werent proper productive sneezes, were repetitive, waxed and waned in severity throughout the day, became more frequent when attention was called to it or during stress, and disappeared during sleep. Proper Tourettes Syndrome is manifest in childhood, not adolescence. The diagnostic criteria indicates that tics must be initially manifest at age 6 or younger. I suggested it was one of several closely related tic disorders or, less likely, a brain lesion along the circuit pathways involved in tic disorders like corpus striatum-thalamus-cortical circuits. that was at the beginning of november. Well it turns out that after a month and dozens of doctors with dozens of theories that all were dead ends an official diagnosis was finally handed down of PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus), which is a Tourettes Related condition discovered a little over a decade ago that I became familiar with at a Tourettes Syndrome Association Medical Symposiam (a CME accreditation seminar I crashed at the national conference in DC). Its basically Tourettes symptoms caused by a fairly rare reaction to a Strep infection which produces micro-lesion like patterns of damage on the aforementioned brain circuits relating to tic disorders. Researchers believe it accounts for 5-10% of Tourettes Syndrome diagnoses. But since it can manifest any time from infancy through teenage years it is sometimes diagnosed as adult tic disorder. she had had a "cold" just before the onset of symptoms, as did her sister. Her sister recovered normally, but she began sneezing intractably. That is about par for the course with PANDAS. So the question is...am I good or am I good.

(11 comments | comment on this)