Post-streptococcal 'complex' movement disorders: unusual concurrence of psychogenic and organic symptoms.
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.
Squintani
Giovanna
G
Neurology Unit, Borgo Trento Hospital of Verona, Italy. neurogio@tiscali.it
Tinazzi
Michele
M
Gambarin
Mattia
M
Bravi
Elena
E
Moretto
Giuseppe
G
Buttiglione
Maura
M
Defazio
Giovanni
G
Martino
Davide
D
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
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents