title: A case of PANDAS treated with tetrabenazine and tonsillectomy.
abstract: PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) is a rare clinical syndrome characterized by the presence of tics, Tourette syndrome, obsessive-compulsive disorder, or chorea in the context of an immediately precedent streptococcal infection. In this report, we describe the case of an 11-year-old boy who developed PANDAS with severe choreic movements. The criteria for PANDAS diagnosis were met. Moreover, serum antibrain antibodies were present. The patient was initially treated with tetrabenazine 12.5 mg twice daily with remission of the neurological symptoms. Subsequently, the patient underwent tonsillectomy and has been asymptomatic since, with antistreptolysin O titer levels in range.
authors.affiliation: Santa Lucia Foundation IRCCS Hospital, Department F and Laboratory of Neuroanatomy, Santa Lucia Foundation IRCCS at the European Center for Brain Research, Rome, Italy. f.fusco@hsantalucia.it
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Fusco
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pompa
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bernardi
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ottaviani
authors.forename: Carmela
authors.initials: C
authors.lastname: Giampà
authors.forename: Daunia
authors.initials: D
authors.lastname: Laurenti
authors.forename: Maria
authors.initials: M
authors.lastname: Morello
authors.forename: Sergio
authors.initials: S
authors.lastname: Bernardini
authors.forename: Marzia
authors.initials: M
authors.lastname: Nuccetelli
authors.forename: Umberto
authors.initials: U
authors.lastname: Sabatini
authors.forename: Stefano
authors.initials: S
authors.lastname: Paolucci
mesh_terms: D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D000989:Antistreptolysin / Q000097:blood; D001323:Autoantibodies / Q000097:blood; D020274:Autoimmune Diseases of the Nervous System / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D001921:Brain / Q000276:immunology; D002648:Child; D002819:Chorea / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D013290:Streptococcal Infections / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D013577:Syndrome; D013747:Tetrabenazine / Q000627:therapeutic use*; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D018726:Anti-Dyskinesia Agents; D001323:Autoantibodies; D000989:Antistreptolysin; D013747:Tetrabenazine