Two cases of paediatric autoimmune neuropsychiatric disorder associated with group A beta haemolytic streptococcal infection

Hemamali Perera,Malika Weerasinghe,Geetha M Sathiadas

doi:10.4038/sljch.v39i1.1633

Abstract

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Highlights

Prominent neurological and/or psychiatric sequelae occur in a small percentage of children with streptococcal infection
Published research guidelines for diagnosis of PANDAS specify the presence of a tic disorder and/or obsessive compulsive disorder; prepubertal age at onset between 3 and 12 years; abrupt onset and /or episodic course of symptom severity; temporal association between symptom exacerbations and streptococcal infection, confirmed by positive culture and / or elevated anti streptococcal titres; and the presence of neurological abnormalities during periods of symptom exacerbation[2]
But not obsessive-compulsive disorder (OCD) was diagnosed in our patients, though the two may occur together

Summary

Introduction

Prominent neurological and/or psychiatric sequelae occur in a small percentage of children with streptococcal infection. S.A., a 9 year old boy, presented with involuntary jerky movements of head, neck and shoulder regions of 4 months duration. There were no involuntary vocal utterances, excessive eye blinking or jerky movements elsewhere in the body.

Results

Conclusion