More evidence my decision to finish up premed and go to med school is correct

[doc_neuro]

About a month ago Tristan posted this article about a girl with intractable sneezes (12,000 a day roughly) that was baffling doctors. I noticed right away the tic like nature of it and suggested it was a tic disorder related to Tourette Syndrome. They clearly werent proper productive sneezes, were repetitive, waxed and waned in severity throughout

Comments

[gunslnger]

It just means a lot of doctors aren't really thinking very hard. I know very little about rare medical things (aside from what's on Mystery Diagnosis and the like), but I agreed with you after the first paragraph. It's basic logic and analytical thinking. It's hard to get good programmer's in the same fashion. It takes the same kind of thinking.

[doc_neuro]

part of the issue is that a lot of doctors are not aware of the condition itself or its ins and outs. So they end up fumbling around in the dark. The Tourette Syndrome Association puts on CME seminars on it all over the country but while they have made progress it still isnt as common knowledge in the medical community as we would like for it to be.

[gunslnger]

That's what computers are for...

[doc_neuro]

problem is there is a lot of info on the internet, plenty of it bogus, and you have to know what you are looking for. Internet research is no substitute for a CME seminar lectured by the top researchers in the field.

[doc_neuro]

thank you. but I'll tell you what, far more gratifying is being right when lots of smart people are wrong. I'm currently wearing a look so smug it ought to be fined. Does that make me a bad person?

The Two Standpoints

[rawmr]

1 for 1, you're batting a 1,000. ;-)~ Seriously though, good call. Interesting note, I am sure that those with non-pandas Tourettes can be treated just as I have done with Apergers. But when you introduce a serious infection, as with pandas or CFS (as I had for many years), the behavior problems are far more difficult to cope with. Things like classical Tourettes or Autism affect the autonomous brain functions, it is primarily involuntary behavior. But infections affecting the brain most definitely impair conscious functioning, and this limits what you can voluntarily do in terms of modifying behavior. An infection-type of insult to the brain really must be diagnosed as such.

wait a minute

[rawmr]

Know that I said it, I probably shouldn't just lump isolated strep infections with the something like the widespread infectious state you find with CFS-like disorders. But both produce micotoxin, and I think this is in large part responsible for the chemical imbalance issues that affect conscious brain function.

Re: wait a minute

[doc_neuro]

this one is a little different. There is some speculation that PANDAS cases occur mainly in people who already have something of a genetic predisposition for Tourette Syndrome but do not express the gene to a level that would cause symptoms. Unfortunately sample size is a problem both with TS and particularly with PANDAS studies because they remain seriously underdiagnosed, so they've had significant problems getting a sample size large enough to prove that theory with any degree of certainty. I actually have a good friend from Tulane who I spotted as a TS case right away who comes from a family of clincal psychologists that did not recognize her tics for what they were.

Re: The Two Standpoints

[doc_neuro]

actually TS and PANDAS tend to respond to similar treatment regimens...there are some discrepancies, but significant enough overlap that researchers feel study of PANDAS cases will lead to greater understanding of Tourettes Syndrome.