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.
MeSH terms
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Adolescent
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Anti-Bacterial Agents / therapeutic use
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Anti-Inflammatory Agents / therapeutic use
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Autoimmune Diseases of the Nervous System / microbiology
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Autoimmune Diseases of the Nervous System / pathology*
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Autoimmune Diseases of the Nervous System / psychology*
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Electromyography
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Gait Disorders, Neurologic / etiology
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Gait Disorders, Neurologic / physiopathology
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Humans
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Male
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Mental Disorders / etiology
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Mental Disorders / pathology*
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Mental Disorders / psychology*
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Movement Disorders / etiology
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Movement Disorders / pathology*
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Movement Disorders / psychology*
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Muscle, Skeletal / physiopathology
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Pharyngitis / complications
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Pharyngitis / microbiology
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Recurrence
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Streptococcal Infections / microbiology
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Streptococcal Infections / pathology*
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Streptococcal Infections / psychology*
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Tics / etiology
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Tremor / etiology
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Tremor / physiopathology
Substances
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Anti-Bacterial Agents
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Anti-Inflammatory Agents