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.