Journalism Rochester Science

The grey area in LeRoy: when is a diagnosis not a diagnosis?

The latest developments in LeRoy include the arrival and press release of a New Jersey doctor who specializes in identifying a syndrome called PANDAS (Pediatric Acute Neurological Disorder Associated with Streptococcus) or as its apparently been renamed, PANS (Pediatric Acute Neurological Syndrome). So, if we may take a step back and look at the current top contenders for culprits, we have:

  1. Mass Hysteria (a syndrome)
  2. PANS (a syndrome)
  3. An unproven link between TCE and Tourette’s-like symptoms

Doctor Trifiletti states that mass hysteria is a “diagnosis of exclusion,” basically meaning a diagnosis of last resort. But his own pet disorder is in fact no more specific than mass hysteria at all. Whereas mass hysteria is thought to be brought on by stress, PANDAS is believed to be brought on by Streptococcus (strep throat, basically). The only reason one might be perceived as better than the other is if we dismiss the idea of communicable psychological disorder.

But that the name PANDAS was changed to PANS suggests that this link, too, is in doubt. Or at least, perhaps more links have emerged. PANDAS is not even recognized officially as any kind of disorder at all.

As a person who blogs about and dearly loves science, I would never suggest that finding the actual cause of the LeRoy girls’ symptoms is unimportant. But looking at the current list of suspects, you do have to wonder what immediate benefit that answer will provide those girls and their parents?

I’ve discussed what a syndrome is before, but basically: it’s a set of symptoms with no known cause. If the three best answers include two syndromes and a potential red herring, aren’t we back where we began?

The treatment for PANDAS appears to be a course of antibiotics and vitamins. The treatment for mass hysteria is a few trips to the psychologist and maybe a course of anti-anxiety medication. The treatment for the TCE “intoxication” would probably depend on whether or not that actually exists.

Maybe its time to focus on getting those kids better.

Rochester Science

“Mass Hysteria” in Leroy: not the only case?

By now, most of us have heard a fair amount about the girls in LeRoy who all simultaneously came down with the same mysterious symptoms and suffered with them for four months or so. The symptoms resembled those of Tourette’s Syndrome, a complex neurological disorder that is usually identified by motor and verbal tics.

In this case, the girls were all tested for a battery of potential causes, from drugs to environmental causes like CO2 or other pollutants. All came up negative. In short: no solution to the mysterious problem that came as fast as it went.

Earlier today, the Buffalo News reported that a professor at U of Buffalo, Dr. Lichter, identified one possible culprit as being “mass hysteria.” This diagnosis has been met with a fair amount of skepticism, and its pretty hard to imagine a group of people all suffering from the same affliction without there being some specific epidemiological cause. Specifically of the physical kind.

But as it turns out, mass hysteria is an acknowledged syndrome in the medical community which has been studied more deeply in recent years. Previously, mass hysteria has not received as much attention as it’s currently getting, which in part explains the lack of information and the public’s resistance to it as a diagnosis.

In fact, here is a report from 2004 outlining an almost identical case in North Carolina. In this case, 10 girls of various backgrounds and health conditions all came down with seizures symptoms similar in this case to syncope – a condition wherein the patient loses consciousness due to loss of blood when they stand up.

In both cases, the girls are similar in age and go to the same school, but this is where the similarities stop. They are of different ethnic backgrounds, don’t share classrooms despite being in a very small rural school – yet another similarity to the LeRoy case.

One thought that jumps out in my head is: Is it possible these girls maybe are doing a drug for which we cannot screen, such as the currently-popular fake weed and bath salts? In the North Carolina case, they don’t appear to have tested for drugs at all, merely asked. But in the case of the LeRoy students, they appear to have been tested.

I don’t mean to say that they *were* doing these drugs, just wondering if bath salts and similar compounds could be tested for. I’ll have to look into that.

In the meanwhile, it bears mentioning that a “syndrome” is not a disease: syndrome is a word the medical community uses to denote a collection of symptoms for which a specific cause has not yet been identified. Chronic sleep disorder, Tourettes and Mass Hysteria all fall under these categories.

They may all eventually have a specific cause attributed to them. Or perhaps not. But in looking for clues, its important to understand that not every puzzle yet has a solution.