Re: Le Roy, NY, USA: Unusual outbreak of Tourette-like symptoms in 6 students at Junior-Senior High School
Re: Le Roy, NY, USA: Unusual outbreak of Tourette-like symptoms in 6 students at Junior-Senior High School
http://rms.medhyg.ch/article_p.php?ID_ARTICLE=RMS_247_0925
we don't know what happen ( need more informations ) juste note that there is sex ratio for NDMA encephalitis ( I don't know for the other forms of autoimmune disease of the brain )
automatic translation :
NMDA Encephalitis (N-methyl-D-aspartate)
This damage affects
mainly young women and
may be of paraneoplastic paraneoplastic or not.
In a recent review,
more than 90% of patients are women with an age ranging from 5 to 76 years.18 The first description for women with a teratoma ovarien.19 Today,
there is evidence that only 59% of patients positive for anti-NMDA have a tumor associated. The removal of the tumor or immunotherapy provides good recovery of symptoms despite a severe clinical picture.
Children may also be affected, according to a study récente.20, 21for The majority of patients, the initial symptoms are psychosis or other psychiatric symptoms (agitation, anxiety, etc.., 77%). Epileptic seizures occur in 76% of cases.
Abnormal movements like dyskinesia, choreoathetosis, dystonia are present in 86% of cases. There is also autonomic instability in 69% of cases. A case of opsoclonus-myoclonus was successfully treated a patient for 23 years.22
The EEG is abnormal in almost all patients. The MRI showed hyperintensities in FLAIR or T2 in 60% of cases at the medial temporal lobe of the basal ganglia and cerebral cortex. In 40% of cases, MRI is normal. A recent observation by our group, through functional imaging, suggests a hypermetabolism in the basal ganglia, which correlates with the course of the disease and probably represents the counterpart of movements anormaux.23 The CSF is abnormal in 95% of cases with the presence of oligoclonal bands in 26 of 39 patients tested (66%). The clinical course can be dramatic, require resuscitation facilities and prolonged hospitalizations. The median duration of hospitalization was 2.5 months (one to fourteen months). Immunological therapies early (before four months of evolution) seem to lead to a better prognosis. It is the same for a tumoral origin. If the tumor is diagnosed and treated, recovery may be complete or persistent mild deficits.
All major components of immunotherapy (corticosteroids, immunoglobulin, and plasmapheresis) is used without being able to define a single or combination therapy as the most effective for all patients. It is reported one to three relapses in five patients, mainly in the absence of tumor with a median of eighteen months (and up to 84 months after the first attack) .18