title: Post-streptococcal 'complex' movement disorders: unusual concurrence of psychogenic and organic symptoms.
abstract: Post-streptococcal neuropsychiatric disorders encompass a broad spectrum of movement disorders, including tics, stereotypies, dystonia and tremor. We report the case of a 15-year-old boy who presented with a relapsing-remitting combination of psychogenic and organic movement disorders. Both relapses occurred after an episode of streptococcal pharyngitis and consisted in motor and phonic tics, an atypical gait disorder, and severe worsening of a pre-existing psychogenic tremor of the right hand. After each relapse, both psychogenic and 'organic' symptoms concomitantly remitted after the administration of an association of oral steroids and antibiotics. The peculiarity of this case consists in the coexistence of psychogenic and organic symptoms subsequent to streptococcal infection, and broadens the clinical spectrum of post-streptococcal neuropsychiatric disorders.
authors.affiliation: Neurology Unit, Borgo Trento Hospital of Verona, Italy. neurogio@tiscali.it
authors.forename: Giovanna
authors.initials: G
authors.lastname: Squintani
authors.forename: Michele
authors.initials: M
authors.lastname: Tinazzi
authors.forename: Mattia
authors.initials: M
authors.lastname: Gambarin
authors.forename: Elena
authors.initials: E
authors.lastname: Bravi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Moretto
authors.forename: Maura
authors.initials: M
authors.lastname: Buttiglione
authors.forename: Giovanni
authors.initials: G
authors.lastname: Defazio
authors.forename: Davide
authors.initials: D
authors.lastname: Martino
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D020274:Autoimmune Diseases of the Nervous System / Q000382:microbiology / Q000473:pathology* / Q000523:psychology*; D004576:Electromyography; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology / Q000473:pathology* / Q000523:psychology*; D009069:Movement Disorders / Q000209:etiology / Q000473:pathology* / Q000523:psychology*; D018482:Muscle, Skeletal / Q000503:physiopathology; D010612:Pharyngitis / Q000150:complications / Q000382:microbiology; D012008:Recurrence; D013290:Streptococcal Infections / Q000382:microbiology / Q000473:pathology* / Q000523:psychology*; D020323:Tics / Q000209:etiology; D014202:Tremor / Q000209:etiology / Q000503:physiopathology
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents