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Tourette syndrome or PANDAS-a case report
Rhea Singh1, Nataliya Nekrasova2, Dmytro Butov3
1Kharkiv National Medical University, Kharkiv, Ukraine.
Wiener Medizinische Wochenschrift (1946)
|September 21, 2020
Summary
Tourette syndrome (TS) reemergence in a late adolescent was observed following a streptococcal infection, potentially linked to PANDAS. Treatment involving medication and behavioral therapy showed improvement in tic severity.
Area of Science:
- Neurology
- Immunology
- Pediatric Psychiatry
Background:
- Tourette syndrome (TS) is a common neuropsychiatric disorder not fully understood.
- Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) links tic and psychiatric disorders to streptococcal infections.
- Late adolescent onset of TS symptoms is less common but documented.
Observation:
- A 19-year-old female with a history of anxiety and OCD experienced a recurrence of motor and phonic tics.
- The patient developed new-onset tics after a severe tonsillitis infection.
- Streptococcus pyogenes was identified in blood and cerebrospinal fluid cultures.
Findings:
- Magnetic resonance imaging revealed hypo-intense changes in the caudate nucleus.
- The case suggests a potential reemergence of TS due to an immunological reaction or PANDAS.
- The patient's condition improved with clonazepam, fluoxetine, and behavioral therapy.
Implications:
- This case highlights the possibility of late-onset TS or PANDAS in adolescents.
- Understanding the link between streptococcal infections and tic disorders is crucial for diagnosis and treatment.
- Further research into the immunological underpinnings of TS and PANDAS is warranted.
