Doctors Diagnose Girl Who Sneezes 12,000 Times ~

[mzmolly]

Lauren Johnson, the 12-year old Virginia girl who sneezes 12,000 times a day has finally gotten an official diagnosis from her doctors. The condition is called Pediatric Neuropsychiatric Disorder Associated with Streptococcus, abbreviated as PANDAS.

PANDAS is a term that describes a subset of children who have obsessive compulsive disorder (OCD) or tic disorders such as Tourette’s syndrome. The symptoms worsen immediately following an infection from the bacteria streptococcus.

Researchers first described the condition in the American Journal of Psychiatry in 1998.

Symptoms of the condition include motor or vocal tics, obsessions, and/or compulsive behavior. Children may also become irritable, have sleep disturbances, separation anxiety and fine and gross motor changes, such as changes in handwriting. The mechanism of onset is unclear, but researchers at NIMH are pursuing a theory that it is similar to that of Rheumatic Fever, an autoimmune disorder also triggered by strep. Instead of producing antibodies to combat an incoming pathogen, the body mistakenly attacks other body functions such as certain parts of the brain, setting off abnormal movements and actions.

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Edited to add link to video here: http://www.wavy.com/dpp/news/local_news/Sneezing-girl-officially-diagnosed

[jberryhill]

1. Why Did They Diagnose Her That Many Times?

Getting a second opinion is one thing, but that's overdoing it IMHO.

[mzmolly]

2. I only know of one diagnosis?

They were given various suppositions that did not fit her case. Thankfully the parents pursued answers aggressively.

[SidDithers]

6. Hehe...

unintentional headline writers humour can be pretty funny :)

Sid

[HuckleB]

3. Interesting.

PANDAS has also been noted in a couple of cases of "sudden onset" anorexia. Strep history is something I always get when I do initial evaluations on patients. I wonder if they sneezing with this girl is actual sneezing or considered to be a tic or an OCD behavior. And then there's the question of how PANDAS gets things started, and brain plasticity may or may not take it from there. Of course, we're a long way away from figuring that stuff out.

Cheers!

[mzmolly]

4. At times it's difficult to tell OCD from tics

but I'm thinking it's more of a tic given there appears to me more of a physical sensation vs. a thought process.

Interesting about anorexia. I knew that anorexia was associated with OCD, but I did not know that PANDAS could explain a sudden onset?

Good for you on the strep history! Not many physicians do that.

I have heard that titers often show strep when a culture may not?

[HuckleB]

5. Yeah, we always do a titer when we're looking for PANDAS.

I don't know how many cases of anorexia have been noted, thus far. But I know there were a enough that an eating disorders clinic where I worked did titers on every AN patient, just to be certain. It seems like more of the pediatricians I know are now looking for PANDAS, as a possible etiology for such symptoms, too. Still, I think the hiccups would throw most people for a loop.

[mzmolly]

7. There has been debate that PANDAS is not a legit

diagnosis among many in the medical community. I'm glad to see that the diagnosis is getting a bit more respect of late.

I recall another girl who was a "sneezer" a couple years ago. She too was diagnosed with Tourette Syndrome, but I don't recall if she was tested for strep or not?

The link between mental health and illness is fascinating isn't it? I've recently read about schizophrenia being linked to things like bacteria in cat stool or influenza in pregnancy? Encouraging, given antibiotics are currently able to treat some forms of mental illness.