A case of PANDAS treated with tetrabenazine and tonsillectomy.
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.
Fusco
Francesca Romana
FR
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
Pompa
Alessandra
A
Bernardi
Giorgio
G
Ottaviani
Fabrizio
F
Giampà
Carmela
C
Laurenti
Daunia
D
Morello
Maria
M
Bernardini
Sergio
S
Nuccetelli
Marzia
M
Sabatini
Umberto
U
Paolucci
Stefano
S
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
D018726:Anti-Dyskinesia Agents; D001323:Autoantibodies; D000989:Antistreptolysin; D013747:Tetrabenazine