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Conversion disorder in New York?
March 8, 2012 5:30 AM   Subscribe

What happened to the girls in Le Roy? (NYTimes) 18 girls in Le Roy, New York have been suffering from tics and seizures. Neurologists believe the cause is conversion disorder (AKA hysteria) combined with mass psychogenic illness. Others have suggested environmental causes, or PANDAS.

Girls interviewed by Dr. Drew. (YT)

Portions of interviews with the neurologists involved. (YT)
posted by OmieWise (95 comments total) 25 users marked this as a favorite

 
Turns out "PANDAS" is not nearly as much fun as pandas.
posted by valkyryn at 5:47 AM on March 8, 2012 [7 favorites]


something's fishy here...
posted by ReeMonster at 5:49 AM on March 8, 2012 [1 favorite]


This is really a fascinating article. Thanks for posting.
posted by (Arsenio) Hall and (Warren) Oates at 5:51 AM on March 8, 2012 [1 favorite]


On Saturday, Jan. 28, Brockovich’s team, accompanied by a crew from CNN and a handful of other reporters, arrived at the Le Roy high school to perform their tests, only to find members of the local police waiting to escort them off the property. The mood in Le Roy, already tense, was now charged with anger. “I will tell you that usually in settings or situations like this, when I’m confronted by officials barring access to something, they usually have something to hide,” Bob Bowcock, one of Brockovich’s testers, told CNN.

In the days that followed, groups of residents made their way to the site of the former spill, to compare notes and to see what there was to see. “I am very angry,” said Robyn Horn, a mother of four. “I mean, what are they trying to hide? They wouldn’t let them take a little bit of soil?” The Batavian, a local online newspaper, posted a poll asking, “Are you confident Le Roy schools are looking out for the best interest of students?” Of the 1,600 people who responded, 67 percent answered no.
Why on earth would you do this? Why not let people do tests. What is with the impulse some people have to try to prevent investigation even when they almost certainly have nothing to hide?
posted by delmoi at 5:51 AM on March 8, 2012 [1 favorite]


It doesn't take House MD to realize that the seizures are brought on by the well known adverse interaction between Lucky Charms and Fruit Loops.(see photo NY Times article)
posted by humanfont at 5:52 AM on March 8, 2012 [2 favorites]


Why on earth would you do this? Why not let people do tests. What is with the impulse some people have to try to prevent investigation even when they almost certainly have nothing to hide?

Yeah, I agree. It seems like a completely boneheaded move, even if the hoopla surrounding Erin Brokovich showing up is a pain in the ass.
posted by OmieWise at 5:57 AM on March 8, 2012


OCD caused by strep. Schizophrenia caused by cat poop.

The world is scary.
posted by DU at 6:00 AM on March 8, 2012 [2 favorites]


Not to be a buzzkill but I'm finding it hard to make light of this after watching the video of those girls being interviewed. Jesus, that's gotta be rough. Hope they figure out what's going on soon.
posted by (Arsenio) Hall and (Warren) Oates at 6:00 AM on March 8, 2012 [1 favorite]


Time to get out the dunking stool and start collecting spectral evidence, although I will warn you in advance that no good will come of it....
posted by GenjiandProust at 6:01 AM on March 8, 2012 [5 favorites]


something's fishy here...

Indeed, and the NY Times article is part of the smell. The 1970 spill was enormous and, keep in mind, over 40 years ago. The cyanide and TCE have long become part of the soil and water in the Le Roy area. To blame this on hysteria and/or breakfast cereal and ignore the obvious environmental possibilities is just irresponsible journalism.

Of course, you also have the Le Roy schools refusing to allow soil sampling, so it's not just the journalism that irresponsible.
posted by tommasz at 6:01 AM on March 8, 2012 [3 favorites]


Cox offered her best assurances: that environmental testing had already been done; and that no known environmental toxin, the country’s best experts agreed, would cause these particular symptoms or account for an affliction affecting almost exclusively teenage girls and not boys or teachers or any other staff members.

Strange that only teenage girls are affected. Now I see why "hysteria" is even being mentioned as a possible explanation.

What is with the impulse some people have to try to prevent investigation even when they almost certainly have nothing to hide?

Investigations not properly conducted - and leading to false results - could be as bad as not conducting any tests at all? Especially if the aforementioned "hysteria" is a real thing.
posted by three blind mice at 6:04 AM on March 8, 2012 [5 favorites]


Conversion disorder is fascinating.
posted by the young rope-rider at 6:12 AM on March 8, 2012 [3 favorites]


If something like that had happened a couple centuries ago, they would have started burning witches.

On the other hand, Rick Santorum is now a credible candidate for the Presidency, so it's not too far beyond the pale to think we might end up dealing with this one in much the same way.
posted by Naberius at 6:13 AM on March 8, 2012 [9 favorites]


I spent about 4 years with a conversion disorder, or something that was called non epileptic seizure disorder, or pseudo-seizures, depending on who was doing the talking. It was a lot about stress, not eating at all, sleep patterns, and a unchecked anxiety/depressive disorder. I went thru telemetry, neuro intervention, a bunch of meds, and everyone thought it was medical. It only really got sorted by a long, long stay as an in/outpatient in a pysch facility. The interesting thing, was when i was at the facility, my symptoms (mostly literally failing to the ground in a swoon/faint--conversion disorder has a eitlogical heritage with hysteria and neurosis and all of those victorian lady diseases, so for a good portion of my twenties, i had some interesting gender stuff going on)

One of the things that the shrink at the hospital (who was mostly useless) thought was that i was doing it for attention, and as an already quite frightened young adult, who was not good at dealing with trauma, i had this paranoid fear that it was my fault, that all of this was my fault, and so the tension about fault, and blame and causation came to me pretty hard.

I think that my friend Danielle told me, and this was helpful, was that Conversion disorder was the body reasserting itself. That it was telling me that I was no longer in control, that the trauma had over taken my life, and I needed help dealing with it. It was no ones fault, it was the body telling the mind, in a most forceful way, that I am here, and that being here, I needed to be tended.

I am not sure that these girls have any trauma, but one of the things that i am not sure is recognized, is that being a high school student; with the ambiguity about the future, the hormones of puberty and its aftermath, the SATs, the college plans, the loneliness is both incredibly stressful, and incredibly bodily. But it is ambiguous about it's bodily sense, and this ambigouity makes sense to convert to something more explicit.

I am not trying to make these women';s stories about myself, but it seems familar.
posted by PinkMoose at 6:15 AM on March 8, 2012 [57 favorites]


O/T.. I haven't reviewed the links yet but the mass hysteria part reminded me of the weird stories behind the 'dancing mania' over a couple of centuries in Europe, particularly in Taranto in Italy (tarantism).
posted by peacay at 6:16 AM on March 8, 2012 [2 favorites]


I am not sure that these girls have any trauma, but one of the things that i am not sure is recognized, is that being a high school student; with the ambiguity about the future, the hormones of puberty and its aftermath, the SATs, the college plans, the loneliness is both incredibly stressful, and incredibly bodily. But it is ambiguous about it's bodily sense, and this ambigouity makes sense to convert to something more explicit.

If we were talking about one girl, this explanation could make sense. 18 girls in a cluster, not so much. Why does one school happen to stress the kids so much that 18 of them all develop the same symptoms at the same time? Examining their school histories (i.e. have a terrible test with an awful teacher coming up) could say, but a medical explanation seems more likely.
posted by DU at 6:26 AM on March 8, 2012 [1 favorite]


One of the things that Conversion disorder does, and no one can quite figure out why, is translate across people. So one person can collapse into this disorder, and then others pick up on it, without having the same triggers or signals. It's pretty historical. St Vitus Dance, some late medieval convents, the salem witch trials, the Tantarism that peacay mentions, etc. It can be very easily become a quirk of close communities, esp. communities that have a strong and homogenous value system.
posted by PinkMoose at 6:33 AM on March 8, 2012 [8 favorites]


It would be rather odd for environmental contamination to suddenly affect a cluster of girls from a well-defined cohort 40 years after the initial contamination, with no evidence of affects prior to this or outside that cohort.
posted by lodurr at 6:36 AM on March 8, 2012 [24 favorites]


... as far as why they'd turn away Brokovich, that's obvious: Leroy is a relatively small town, pretty socially conservative, they have a bit of a small town mentality. They're hinky enough about becoming a bedroom community (it's an outer-burb of Rochester, NY) and the social change that comes along with that. It actually makes perfect sense to me that they'd do this with nothing particular to hide.
posted by lodurr at 6:38 AM on March 8, 2012 [2 favorites]


I think one thing we need to be careful about is dismissing conversion disorder as "hysteria" (I see this more from people who are skeptical about the diagnosis of conversion disorder).

Just because something is caused by a brain disorder rather than a 'body disorder' doesn't make it any less real. It doesn't mean these girls are 'faking it' or that no factors are environmental in origin.
posted by muddgirl at 6:45 AM on March 8, 2012 [32 favorites]


The CBC had a nice long piece on this a while back; on the current
posted by NiteMayr at 6:52 AM on March 8, 2012 [1 favorite]


I don't think conversion is fake or far fetched. I find my kids will emulate certain nervous tics from other kids in class without having made conscious decisions to do so. They can be reminded to stop and it goes away, but left unchecked these can be pretty well integrated into their own habits. Skimming TFA it seems that these kids knew each other. The waking from sleep part would make me lean towards environment though.

I also find the improper use of 'like' and the elimination of adverbs from speech as socially transmitted diseases too, but that's another thread.
posted by drowsy at 6:54 AM on March 8, 2012 [2 favorites]


Pontypool changes everything!
posted by dr_dank at 6:55 AM on March 8, 2012 [8 favorites]


As a regular reader of the Fortean Times, reports of symptoms and behaviour similar to this breaking out amongst groups are very common from all around the world. From the reports in the Fortean Times, these outbreaks seem to be far more common amongst groups of school-age girls than anything else. Upon investigation, no-one seems to be able to find reasons for any of these outbreaks, and it usually gets classified as mass hysteria. Here is one article on the subject.
posted by fimbulvetr at 6:56 AM on March 8, 2012 [4 favorites]


It's a really well-defined cohort with lots of associated behavioral norms and routinized behaviors. I think it would probably be more surprising if conversion were not involved in some way.
posted by lodurr at 7:00 AM on March 8, 2012 [1 favorite]


Milhouse: I have soy milk. The doctor says the real kind could kill me.

Bart: I wish I was interesting like you.
posted by ShutterBun at 7:03 AM on March 8, 2012 [1 favorite]


I think one thing we need to be careful about is dismissing conversion disorder as "hysteria" (I see this more from people who are skeptical about the diagnosis of conversion disorder).

Just because something is caused by a brain disorder rather than a 'body disorder' doesn't make it any less real. It doesn't mean these girls are 'faking it' or that no factors are environmental in origin.


I very much agree with the second part of your statement, and came in to write something similar regarding DU's comment above. The a priori dismissal of a psychological explanation both radically underestimates the power of the mind and suggestion, and (perhaps counter-intuitively) contributes to the stigmatization of mental disorders. That doesn't mean that "medical" causes aren't possible, but the evidence here at least seems to favor a psychological explanation.

On the other hand, calling this hysteria is by no means dismissing it, and I actually think it's an important part of understanding mental illnesses. Yes, hysteria has unsavory misogynistic connotations, which is part of why the illness was renamed "conversion disorder," but it's the same illness (just as Dissociative Identity Disorder was formerly called Multiple Personality Disorder). Understanding that history is important precisely because it rehabilitates (to my mind) "hysteria" from something used to describe overly emotional behavior to an actual and troubling mental illness.
posted by OmieWise at 7:04 AM on March 8, 2012 [12 favorites]


It actually makes perfect sense to me that they'd do this with nothing particular to hide.

On top of that add the fact that they already know the area's contaminated & they're likely to get back results but they don't know those results will conclusively link to a specific illness and you've got a recipe for a very expensive solution to something that may not be causing the problem at hand as well as opening the door to an equally expensive civil liability and a drag on the local economy from bad publicity to boot. Not something any town relishes at the best of times which these certainly aren't. Right or wrong on the actual cause, I can totally understand their reluctance.
posted by scalefree at 7:09 AM on March 8, 2012 [1 favorite]


Understanding that history is important precisely because it rehabilitates (to my mind) "hysteria" from something used to describe overly emotional behavior to an actual and troubling mental illness.

That ship has sailed, I think, just like we don't use "imbecile" and "moron" as scientific classifications of mental ability. The popular stigma has overwhelmed the medical term. As long as psychological illness continues to be stigmatized, the language we use to describe it will have to continue to flee from leakage into terms of popular abuse.
posted by Horace Rumpole at 7:13 AM on March 8, 2012 [3 favorites]


lodurr: "It would be rather odd for environmental contamination to suddenly affect a cluster of girls from a well-defined cohort 40 years after the initial contamination, with no evidence of affects prior to this or outside that cohort."

Since this is a cohort with strong similarities, it seems possible an environmental trigger could be a part of it as well, perhaps in combination with the area being contaminated. Many beauty, hygenic and household products contain various toxins and known allergens. Was something new introduced? Could have been something that was trendy or popular among girls that age.

The conversion disorder hypothesis is compelling and seems likely. But dismissing the environmental factor strikes me as premature.
posted by zarq at 7:15 AM on March 8, 2012


On the other hand, calling this hysteria is by no means dismissing it,

Thanks OmieWise. For clarity, my comment "Especially if the aforementioned "hysteria" is a real thing" wasn't a dismissal of the affliction, but a qualifier that it may not be the explanation for what is happening in NY. Obviously something is going on, but also obviously no one yet knows what it is.

Also you make a good point about "rehabilitation" of the word. Before this thread, I had no idea what "conversion disorder" was; hysteria was something I could understand and it was helpful (at least for me) for the FPP to add the AKA.

Layman's terms are not necessarily pejorative terms although I understand that professionals tend to see things in this way.

it seems possible an environmental trigger could be a part of it as well

Why only young girls then? Isn't that a bit strange? Is "conversion disorder" more likely in young girls in general? Or is there some toxin that girls are exposed to more than boys? And if it is in the soil how is this explained? Really very strange.

Unfortuntately this sort of investigation runs the risk of bias as "civil liability" is a magnet that tends to point the compass towards explanations that also have deep pockets.

As scalefree says, I can absolutely understand the reluctance of the city to permit amateur investigations. "Nothing to hide" doesn't necessarily mean "nothing to fear."
posted by three blind mice at 7:33 AM on March 8, 2012 [1 favorite]


It's not just adolescent girls. The 2011 book The Great Singapore Penis Panic and the Future of American Mass Hysteria describes an 1967 outbreak of koro, which Wikipedia describes as "a culture-specific syndrome from Southeast Asia in which the person has an overpowering belief that his penis is shrinking and will shortly disappear." Victims are reported to use hands, family members' hands, or clamps and weights to prevent their member from retracting into their abdomen. (Relevant excerpts from medical literature here.)

Of course, it could be possible that some previous toxic spill had seeped into the ground water and made its effects known in penises all over Singapore at exactly the same moment. (A shame that Erin Brockovich and the morning news shows weren't available to go investigate - imagine the headlines.) But 45 years after the fact, the medical literature seems pretty confident in a psychological basis for the condition.

Affecting teenage girls in Le Roy, adult men in Singapore, even (one could argue) "rational" participants in investment bubbles: this is a powerful condition that is worth studying and taking seriously.
posted by mark7570 at 7:40 AM on March 8, 2012 [8 favorites]


"Nothing to hide" doesn't necessarily mean "nothing to fear."

You said it way better than I did. In a word, this.
posted by scalefree at 7:42 AM on March 8, 2012 [1 favorite]


To many parents, the diagnosis was woefully inadequate, even insulting.“It’s a very hard pill for me to swallow — what are we, living in the 1600s?” the guardian of one of the girls said.

Hey, don't knock the physicians of centuries gone by. They might not have had our knowledge of environmental toxins or pathogenic bacteria, but they had some pretty sophisticated theories of mind/body interaction in illness. You would be surprised.

I work on 18th-century medicine, looking at patient and physician experiences of illness. Hysteria turns up a lot, and because we process it now through a lens of haughty Victorians dismissing women as delicate and irrational, it can take time to adjust to ways of seeing it as a legitimate illness. But if you jumped in a time machine and took this description of the girls in Le Roy to a physician of, say, 250 years ago, then a diagnosis of 'hysteria' wouldn't have been an insult. It would have been more like saying "these girls have a real and genuine illness, in which the brain and the body both play a part."

Here's a passage on hysteria from 1784, from a book by Dr. William Cullen, one of the best-known physicians in the Western world at the time:
In the persons liable to the fits of this disease, it is readily excited by the passions of the mind, and by every considerable emotion, especially those brought on by surprise. The persons liable to this disease acquire often such a degree of sensibility, as to be strongly affected by every impression that comes upon them by surprise.
[...]
Having thus endeavoured to distinguish hysteria from every other disease, I shall now attempt its peculiar pathology. With respect to this, I think it will, in the first place, be obvious, that its paroxysms begin by a convulsive and spasmodic affection of the alimentary canal, which is afterwards communicated to the brain, and to a great part of the nervous system.
So, fits of hysteria (and he's very much talking about physical fits, including involuntary motion) are brought on by "the passions of the mind", and a person liable to hysteria is a person who's emotionally highly-strung; but at the same time, it's an illness beginning in the alimentary canal, and then affecting the brain and the nervous system.

Likewise, here's Cullen on hypochondria, typically considered the male equivalent of hysteria:
In certain persons there is a state of mind distinguished by a concurrence of the following circumstances: A langour, listlessness, or want of resolution and activity with respect to all undertakings; a disposition to seriousness, sadness, and timidity; as to all future events an apprehension of the worst or most unhappy state of them; and therefore, often upon slight grounds, an apprehension of great evil. Such persons are particularly attentive to the state of their own health, to every the smallest change of feeling in their bodies; and from any unusual feeling, perhaps of the slightest kind, they apprehend great danger, and even death itself.
[...]
This seems to be particularly well illustrated, by our observing the changes in the state of the mind which usually take place in the course of life. In youth, the mind is chearful, active, rash, and moveable: But, as life advances, the mind by degrees becomes more serious, slow, cautious, and steady; till at length, in old age, the gloomy, timid, distrustful, and obstinate state of melancholic temperaments, is more exquisitely formed.
[...]
Upon the whole, it appears, that the state of the mind which attends, and especially distinguishes hypochondriasis, is the effect of that same rigidity of the solids, torpor of the nervous power, and peculiar balance between the arterial and venous systems which occur in advanced life, and which at all times take place more or less in melancholic temperaments.
[...]
The management of the mind in hypochondriacs is often nice and difficult. The firm persuasion that generally prevails in such patients, does not allow their feelings to be treated as imaginary, nor their apprehension of danger to be considered as groundless, though the physician may be persuaded that it is the case in both respects. Such patients, therefore, are not to be treated either by raillery or by reasoning.

It is said to be the manner of hypochondriacs to change often their physician; and indeed they often do it consistently: For a physician who does not admit the reality of the disease, cannot be supposed to take much pains to cure it, or to avert the danger of which he entertains no apprehension.

If, in any case, the pious fraud of a placebo be allowable, it seems to be in treating hypochondriacs.
He goes on to suggest that the best way to cure a hypochondriac is to recommend fresh air, exercise, and a pattern of business and hobbies which are mentally fulfilling and pleasurable.

So I get that 'hysteria' is a stigmatised term now, and I get why that's so. Still, I wonder if that stigma isn't itself the problem, in a sense. However mistaken the 18th-century physicians were about some things (hysteria originating in the alimentary canal? hypochondria originating here?), being able to describe something as a condition which is best addressed by dealing with lifestyle and thought patterns, which can be fixed by placebos, and which at the same time is a totally real, totally respectable disorder which is in no sense made up by the patient, and which probably contains a decent degree of mind/body interaction to boot, that's a long way from primitive.

Now? Even if we rename 'hysteria' to 'conversion disorder', we still don't have a popular framework for processing it that won't run into huge amounts of resistance from people distinguishing between 'real' illnesses (where real = genuine, physical, bacterial/viral/environmental) and 'psychological' illnesses (where psychological = not a genuine illness, not deserving of respect as such). And I doubt that's much help to the girls in Le Roy.
posted by Catseye at 7:44 AM on March 8, 2012 [30 favorites]


Layman's terms are not necessarily pejorative terms although I understand that professionals tend to see things in this way.

Of course layman's terms are not 'necessarily' pejorative, but when we are speaking about mental health issues, which are poorly understood by the majority of the population, they are more often than not used pejoratively. It's possible that I am knee-jerking because this case involves young girls who are more likely to be dismissed as over-emotional and 'faking it'.

Of course, it could be possible that some previous toxic spill had seeped into the ground water and made its effects known in penises all over Singapore at exactly the same moment. (A shame that Erin Brockovich and the morning news shows weren't available to go investigate - imagine the headlines.) But 45 years after the fact, the medical literature seems pretty confident in a psychological basis for the condition.

I think this is a little simplistic - it's not black-or-white "Either there is an environmental cause and penises are really shrinking OR there is a purely psychological basis." It's possible (I would say likely) that environmental factors increases susceptibility to mass hysteria.
posted by muddgirl at 7:46 AM on March 8, 2012 [3 favorites]


three blind mice: "Why only young girls then? Isn't that a bit strange? Is "conversion disorder" more likely in young girls in general? Or is there some toxin that girls are exposed to more than boys? And if it is in the soil how is this explained? Really very strange. "

Unknown. There are certainly beauty products (and for that matter clothing) that girls are far more likely to wear than boys. Makeup and nail polish, perfumes, tampons and other feminine hygiene products, etc. There are types of makeup that are only worn by girls of a certain age, too -- for example, glittery, brightly colored makeup is much more popular with teens than adults.

I agree. It is very strange. But I think worth not ruling out, too.
posted by zarq at 7:47 AM on March 8, 2012 [1 favorite]


Catseye: "So I get that 'hysteria' is a stigmatised term now, and I get why that's so. Still, I wonder if that stigma isn't itself the problem, in a sense. However mistaken the 18th-century physicians were about some things (hysteria originating in the alimentary canal? hypochondria originating here?), being able to describe something as a condition which is best addressed by dealing with lifestyle and thought patterns, which can be fixed by placebos, and which at the same time is a totally real, totally respectable disorder which is in no sense made up by the patient, and which probably contains a decent degree of mind/body interaction to boot, that's a long way from primitive.

Now? Even if we rename 'hysteria' to 'conversion disorder', we still don't have a popular framework for processing it that won't run into huge amounts of resistance from people distinguishing between 'real' illnesses (where real = genuine, physical, bacterial/viral/environmental) and 'psychological' illnesses (where psychological = not a genuine illness, not deserving of respect as such). And I doubt that's much help to the girls in Le Roy.
"

No, it's not. To that end I would like to see the media avoid dismissing what these young women are going through because they are young women. Which seems to be happening a bit. I think that this may in part be because we as a culture have not yet outgrown the same biases that gave us the word "hysteria" and all its related stigmas. I think it's also in part because our culture has become highly cynical and suspicious of things we can't explain. They're quasi-dismissed automatically as fake, even before they're analyzed in-depth.
posted by zarq at 7:53 AM on March 8, 2012 [1 favorite]


Why only young girls then?

There is, if my memory of the local news reporting serves, at least one young male manifesting the same symptoms.

Also, I'll nth the thought that the ground is almost certainly going to show some degree of contamination if subjected to a thorough enough analysis. Which may or may not have anything at all to do with the outbreak.
posted by tyllwin at 7:54 AM on March 8, 2012


To further complicate matters it could even be a combination effect, for instance something in a product only girls use acting as a trigger for a local contaminant. Smilex come to life. Yeek.
posted by scalefree at 7:55 AM on March 8, 2012 [3 favorites]


I don't think conversion is fake or far fetched. I find my kids will emulate certain nervous tics from other kids in class without having made conscious decisions to do so. They can be reminded to stop and it goes away, but left unchecked these can be pretty well integrated into their own habits

Repeated for emphasis. When my daughter was five she had a friend with asthma who would occasionally draw deep breaths. My daughter really liked this girl, and soon adopted this breathing habit. It was both annoying and worrisome, as we didn't know if she was just imitating her friend or if she'd actually developed some kind of disorder. She had no idea she was doing it, and asking her to stop didn't do anything. She eventually got over it on her own.
posted by schoolgirl report at 7:55 AM on March 8, 2012


I think zarq's point (and it's a good one) is that reactions to chemical toxin exposure can be addititive.

So someone using, say, a certain kind of perfume in NYC may not have any reaction, but if they moved to a town with slightly-elevated levels of toxin in the soil, the combination of the two may be too much and would cause a reaction. Or someone living in Le Roy who doesn't use a certain product may be OK despite the contaminated soil, but if they start using a new tampon it might suddenly cause a reaction that wouldn't happen elsewhere.
posted by muddgirl at 8:09 AM on March 8, 2012 [2 favorites]


hy does one school happen to stress the kids so much that 18 of them all develop the same symptoms at the same time

My kids' therapist was just telling me last week how incredibly common it is for symptoms to show up in clusters in school settings. My son has been having tics and little anxiety attacks that almost look like seizures (he's 7), and, while he is homeschooled, when discussing what might be causing this--the onset was quite sudden--the therapist mentioned that exposure to other kids with these kinds of symptoms is a very common precipitating factor. He said that certain symptoms can spread through a classroom or a grade level very quickly, and usually the "outbreak" dies down on its own.

I'm skeptical of the environmental theories. If the waste was dumped 40 years ago, why is this happening now? Why almost exclusively to teenage girls? And I don't think I'd let Erin Brockovich investigate a school I ran--she's hardly an objective neutral party. She likes publicity (anybody who shows up to do an environmental investigation with TV cameras in tow is suspect in my book) and has an axe to grind.
posted by not that girl at 8:15 AM on March 8, 2012 [5 favorites]


This Radiolab segment talks about the phenomenon of contagious laughter and mass conversion disorders.

I don't think these mass illness events are all that uncommon. This incident reminded me of a case in Saline, Michigan where the high school was evacuated twice in three days because of large numbers of students fainting and feeling nauseated. That case didn't make national news. When I was looking up those links, I found a link to another story of illness shutting down a school in 2007. So that's at least two cases from Michigan in the last 6 or 7 years.

From my own experience working for a pediatric neurologist, the vast majority of our syncope, migraine, and pseudo-seizure patients were girls aged 10-16. I'm surely no expert, but I do notice a slight overlap with those ages and the age range for the onset of puberty in girls.
posted by palindromic at 8:16 AM on March 8, 2012 [4 favorites]


Why only young girls then? Isn't that a bit strange? Is "conversion disorder" more likely in young girls in general?

Very much more likely.

I can't find the article at least until lunch, but an earlier, possibly local, piece about Le Roy suggested that the pattern of progression of symptoms through the community is pretty much diagnostic of conversion disorder. IIRC, the symptoms start almost anywhere, develop in one or more young women of relatively high social standing, and from there progresse to quite a few other young women (and occasionally a few older women/men of any age) within the same community.

Unfortunately, the progression along community/social lines makes it seem less "real" to some people, and more like the afflicted may be"faking it" That seems unfair to me. We know about the nocebo effect. Just because the symptoms are caused by the part of the body inside the skull rather than, say, the liver or the immune system, doesn't mean the symptoms are any less real.

It also means that a disease or disorder that does have an environmental or biological cause, but preferentially affects young women, may be investigated less quickly or less well well. I have hope that the attention given to Le Roy by the press, medical community, and environmental activists will prevent that from happening.
posted by CHoldredge at 8:18 AM on March 8, 2012 [1 favorite]


muddgirl: "...is that reactions to chemical toxin exposure can be addititive."

Yes! That's the phrase I was looking for. Thank you. :)
posted by zarq at 8:20 AM on March 8, 2012


Something that I think people in western cultures seem to struggle with is the idea that the mind and the body are one continuous thing. I blame Descartes and the whole idea of Dualism.

They know that the mind can effect the body. Who hasn't ever felt there heart race at a thought. They know that things in the body can effect the mind. Otherwise how would you explain the mood altering drugs that our society consumes in quantity? Yet we seem to regard the possibility of a negative feedback loop between the two as crazy talk.

I also find it funny that so many people are saying it most be something environmental or it must be something social as if society is not part of our environment. As I recall the intensity of social factors in the adolescent environment was quite high.
posted by The Violet Cypher at 8:23 AM on March 8, 2012 [5 favorites]


I had a long period of stress that clearly helped kick my diabetes into high gear, and also led to serious dental problems.

More recently, a young female relative with a difficult family history has experienced a startlingly broad pattern of symptoms that, together, point to conversion disorder. There was an ER visit where she became glassy-eyed and started repeating phrases without being able to answer most questions, did not socially recognize family members, yet remained aware of her surroundings even as she shed clothing and literally tried climbing the walls. Another time she complained of dizziness and fainting, but failed the ER "hand drop" test by consciously preventing her hand from dropping on her face when the doctor let go of it. And so on. Eventually we weaned her off these apparent attention-getting episodes into therapy, but there's no doubt in my mind that the human mind is capable of "creating" physical symptoms to the point of needing an MRI or something equally sophisticated to rule out a physical cause.

I think that's a key point. As The Violet Cypher mentions, as a society we tend to fear and/or dismiss these relationships. We often speak of illnesses in terms of their symptoms, but physical symptoms do not require a physical cause; but we fear mental illness, so reject it as a potential cause, even if it's a mild stress reaction.
posted by dhartung at 8:51 AM on March 8, 2012


I agree. It is very strange. But I think worth not ruling out, too.

The problem though, is that postponing a diagnosis and keeping an open mind isn't cost free.

As the article notes:
Most cases resolve quickly. Authorities say something reassuring about the environment, the symptoms fade and everyone moves on. “Things only go wrong,” Wessely wrote in 1995, “when the nature of an outbreak is not recognized, and a fruitless and expensive search for toxins, fumes and gases begins. Anxiety, far from being reduced, increases. It is only then that long-term psychological problems may develop.”
posted by Jahaza at 9:20 AM on March 8, 2012 [2 favorites]


Jahaza: " The problem though, is that postponing a diagnosis and keeping an open mind isn't cost free."

A misdiagnosis of 30-40 teenagers would also not be cost free. Especially if reached through a superficial (not thorough and evidence supported) analysis.
posted by zarq at 9:30 AM on March 8, 2012 [1 favorite]


You said it way better than I did. In a word, this.

Better yet, why not use one more tiny word and say "I agree."
posted by ReeMonster at 9:33 AM on March 8, 2012


But that assumes that neurologists and psychologists in Le Roy, along with scientists who have already taken soil samples, are incapable of making an accurate diagnosis. Which is sort of problematic - if neurologists, psychologists, and scientists are incapable of making a diagnosis, then who is?
posted by muddgirl at 9:34 AM on March 8, 2012


Shit, listening to RadioLab would give me seizures just by itself.
posted by spitbull at 9:42 AM on March 8, 2012


Right, as muddgirl says, there's no strong reason to think that the doctors who diagnosed conversion disorder were wrong.
posted by Jahaza at 10:00 AM on March 8, 2012


Or not even wrong, but superficial in their analysis.
posted by Jahaza at 10:01 AM on March 8, 2012


muddgirl: "But that assumes that neurologists and psychologists in Le Roy, along with scientists who have already taken soil samples, are incapable of making an accurate diagnosis. Which is sort of problematic - if neurologists, psychologists, and scientists are incapable of making a diagnosis, then who is?"

My suspicion is that there are too many possible factors involved for them to rule out every possible environmental factor in this short a time frame.
posted by zarq at 10:10 AM on March 8, 2012


Jahaza: "Or not even wrong, but superficial in their analysis."

They still don't know what caused it. They're speculating to the cause and still don't know whether their diagnosis is accurate.
posted by zarq at 10:11 AM on March 8, 2012


Better yet, why not use one more tiny word and say "I agree."

I was trying to be hip, with it, digging the youth scene. I have been informed my phrasing is how the kids with their twitter boxes & facespaces speak. 23-skidoo!
posted by scalefree at 10:16 AM on March 8, 2012 [3 favorites]


But that assumes that neurologists and psychologists in Le Roy, along with scientists who have already taken soil samples, are incapable of making an accurate diagnosis.

We in our ivory tower forum have the luxury of considering all the possible albeit unlikely possibilities. In the real world these kids are dealing with, their doctors don't have that luxury. Unless you're living in an episode of House you're better off looking for horses than zebras. I'm no expert but it looks to me like Conversion Disorder is by far the most likely culprit.
posted by scalefree at 10:23 AM on March 8, 2012 [2 favorites]


Possible possibilities? How awkward is that? I have a very weird writing style sometimes.
posted by scalefree at 10:24 AM on March 8, 2012


They still don't know what caused it. They're speculating to the cause and still don't know whether their diagnosis is accurate.

I'm not sure this accurately represents what the doctors think. I believe that the neurologists have diagnosed conversion disorder, not provisional conversion disorder, or something. There are people unhappy with that diagnosis, but that's not the same thing as saying it's a contested diagnosis in the scientific sense.

When I was putting the post together I ran across a couple of videos from anti-vaxers claiming that vaccines are the common link between these girls, and must be the culprit. Surely we don't need to suspend diagnosing until we can put the fears of anti-vaxers to rest?
posted by OmieWise at 10:27 AM on March 8, 2012 [2 favorites]


OmieWise: " I'm not sure this accurately represents what the doctors think. I believe that the neurologists have diagnosed conversion disorder, not provisional conversion disorder, or something. There are people unhappy with that diagnosis, but that's not the same thing as saying it's a contested diagnosis in the scientific sense. "

Interesting. I'm curious to see where this goes, then.

OmieWise: " When I was putting the post together I ran across a couple of videos from anti-vaxers claiming that vaccines are the common link between these girls, and must be the culprit. Surely we don't need to suspend diagnosing until we can put the fears of anti-vaxers to rest?"

Of course not.

Conversion disorder is a somatoform disorder, in which there are symptoms, but no identifiable physical cause of symptoms. It is diagnosed by eliminating neurological / physiological causes, making sure the patients aren't faking, and then by determining a likely (not absolute) psychological cause. Have they exhaustively eliminated all potential physical causes? Is this an evidence-based diagnosis? It's not hard to understand why some of the parents involved might think that the diagnosis has not been thorough enough.
posted by zarq at 10:52 AM on March 8, 2012


Also, for what it's worth, this isn't a hill I'm clinging to and dying on. I'm just concerned that they covered all their bases in making the final diagnosis. That's all.
posted by zarq at 10:56 AM on March 8, 2012


Have they exhaustively eliminated all potential physical causes?

But that is not possible. Ever. It is always hypothetically possible that an unknown environmental factor (or combination of factors) is responsible in whole or in part for any and every illness that you ever develop. If you were to say that a diagnosis of conversion disorder had to wait until environmental causes had been eliminated as a possible factor you would be saying that the diagnosis of conversion disorder can never be made. You would also be saying that the best treatment for actual cases of conversion disorder (i.e., not ratcheting up everyone's anxiety by jumping into a witch hunt for environmental 'toxins') can never be offered.
posted by yoink at 11:02 AM on March 8, 2012 [8 favorites]


It's interesting that Erin Brockovich remains the most publicly visible and famous of all crusaders against environmental pollutants. The whole story of Hinkley and PG&A's hexavalent chromium contamination is such a muddy one it seems odd that it has become the gold standard in the genre. There's no doubt PG&A played dirty and failed to disclose what they knew about the contamination--so in that sense it's entirely a good thing that they got zinged in that lawsuit. On the other hand, Erin Brockovich's case rested almost entirely on pseudoscience that's basically on a par with anti-vaxxer nonsense. Cancer rates in Hinkley were statistically unremarkable and there's really no scientific evidence to suggest that ingesting Chromium-6 in the quantities that Hinkley's residents were getting in their tap water should cause any health problems whatsoever.

Which is to say that, yeah--I wouldn't let Erin Brockovich with a whole bunch of TV cameras in tow test the soil at a school I was running either.
posted by yoink at 11:15 AM on March 8, 2012 [3 favorites]


yoink: " But that is not possible. Ever. It is always hypothetically possible that an unknown environmental factor (or combination of factors) is responsible in whole or in part for any and every illness that you ever develop. If you were to say that a diagnosis of conversion disorder had to wait until environmental causes had been eliminated as a possible factor you would be saying that the diagnosis of conversion disorder can never be made. You would also be saying that the best treatment for actual cases of conversion disorder (i.e., not ratcheting up everyone's anxiety by jumping into a witch hunt for environmental 'toxins') can never be offered."

True! I meant "have they been as thorough as humanly possible."
posted by zarq at 11:16 AM on March 8, 2012


True! I meant "have they been as thorough as humanly possible."

That's also not a useful standard. It's humanly possible to devote the next hundred years to studying the billions of potential chemical interactions that these girls were exposed to. The standard you want is "have been as thorough as is reasonable." But that's just inviting an argument over what constitutes reasonable thoroughness.

I think testing for all known environmental toxins that are known to have effects similar to the ones exhibited is reasonable. I think testing for specific other toxins that someone can produce a plausible hypothesis about is reasonable. But I don't think it would be reasonable to, for example, try to set up large-scale animal studies of all possible interactive effects between known environmental contaminants and the make-up, perfume, tampax etc. etc. etc. to which these girls might have been exposed to see if one of them happens to produce some promising symptoms. Not when there is a perfectly good psychological diagnosis sitting there which has every evidence in its favor.
posted by yoink at 11:42 AM on March 8, 2012


Er...rereading my comment on Erin Brockovich above I should have written PG&E, not PG&A. It wasn't golf-ball contamination.
posted by yoink at 11:43 AM on March 8, 2012


There was a piece about this on the Science-Based Medicine blog not too long ago. The author concludes that it's almost certainly mass psychogenic illness.
posted by epersonae at 11:47 AM on March 8, 2012 [2 favorites]


yoink: " That's also not a useful standard. It's humanly possible to devote the next hundred years to studying the billions of potential chemical interactions that these girls were exposed to. The standard you want is "have been as thorough as is reasonable." But that's just inviting an argument over what constitutes reasonable thoroughness.

*head desk*

Can you please assume for the sake of argument that I'm not trying to suggest anything that is patently ridiculous and absurd, like "devot[ing] the next hundred years to studying the billions of potential chemical interactions that these girls were exposed to."?? I'm obviously not suggesting that. Your little reductio ad absurdum argument is not what I meant.

I think testing for all known environmental toxins that are known to have effects similar to the ones exhibited is reasonable. I think testing for specific other toxins that someone can produce a plausible hypothesis about is reasonable.

Which is what I meant, yes.

But I don't think it would be reasonable to, for example, try to set up large-scale animal studies of all possible interactive effects between known environmental contaminants and the make-up, perfume, tampax etc. etc. etc. to which these girls might have been exposed to see if one of them happens to produce some promising symptoms.

Okay. I think it would be possible to find a happy medium there, but I'm not particularly interested in nitpicking the details with you when you're fabricating wild arguments that I'm not making from out of thin air, thanks.

Not when there is a perfectly good psychological diagnosis sitting there which has every evidence in its favor."

I ask again, what evidence is present? Is additional information to a psychological cause available or did they settle on "stress"?
posted by zarq at 11:53 AM on March 8, 2012


epersonae: "There was a piece about this on the Science-Based Medicine blog not too long ago. The author concludes that it's almost certainly mass psychogenic illness."

Thank you for this. It was exactly what I was asking for.
posted by zarq at 11:55 AM on March 8, 2012 [1 favorite]


When I was putting the post together I ran across a couple of videos from anti-vaxers claiming that vaccines are the common link between these girls, and must be the culprit.

And they all ingested dihydrogen monoxide!
posted by kamikazegopher at 12:36 PM on March 8, 2012 [2 favorites]


One simple soil test would kill the debate. Isn't your curiosity in the slightest bit aroused by what the soil tests would show? It's not as though there isn't a long history of public schools in New York (particularly those in poor and working class neighborhoods) suffering from environmental problems that cause developmental disorders and other health problems for their student populations.

Maybe that's really not what's going on here, and the psychologists are right on the money. But why leave that one simple stone unturned? Just because it might yield a result that creates bad publicity? Because we're worried the outcome might not be as easily dismissed as we'd like? That seems like a weird approach to scientific reasoning.

For my part, I guess I'm just too curious by nature to be comfortable leaving such an obvious avenue of investigation neglected.
posted by saulgoodman at 12:39 PM on March 8, 2012


People with panic attacks can have these symptoms and also difficulty swallowing, and episodes that may resemble certain types of seizures with feelings of being separate from reality or from themselves. These are physical symptoms resulting from pure emotional stress.
See, it's statements like this that I find sort of problematic (and this is probably getting a little off-topic). What is 'pure emotional stress'? It seems to me like the article is assuming the fact that psychological disorders should not have any more stigma than physiological disorders, without taking the next step towards the idea that the line between psychological and physiological disorders is incredibly blurry.

I think one minor, but unfortunate, consequence of such a framing is shown in the comments to that artice:
On the other hand, CAM might be the answer here. We have a disease which is largely in the patient’s heads. What better to fix it is imaginary treatment administered by a practitioner who’s spent years learning how to bamboozle people into feeling better?
I can't imagine a rational, modern person suggesting that someone with depression-related (psychogenic!) pain take a homeopathic pain reliever.
posted by muddgirl at 12:40 PM on March 8, 2012


One simple soil test would kill the debate.

Soil tests have been performed, apparantly repeatedly.
posted by muddgirl at 12:41 PM on March 8, 2012


In the case of the children at LeRoy the doctors on the case report that they have been thoroughly evaluated, including screening for any toxins, infections, or signs of a physical illness, with completely negative results. The school has been examined also, and no environmental toxins or chemicals have been discovered.

Aha--missed this bit from epersonae's link. So it looks like they have turned that stone after all.
posted by saulgoodman at 12:42 PM on March 8, 2012


So next question: what is this school/it's student culture doing to put its girls under so much stress?
posted by saulgoodman at 12:44 PM on March 8, 2012


Why is this bit even in the NY Times article if it isn't true?
“I am very angry,” said Robyn Horn, a mother of four. “I mean, what are they trying to hide? They wouldn’t let them take a little bit of soil?” The Batavian, a local online newspaper, posted a poll asking, “Are you confident Le Roy schools are looking out for the best interest of students?” Of the 1,600 people who responded, 67 percent answered no.
posted by saulgoodman at 12:47 PM on March 8, 2012


So next question: what is this school/it's student culture doing to put its girls under so much stress?

I think the Times article explored that pretty well. They have parents with chronic illnesses, or lost a close family member, or have a history of personal violence, or some combination of those factors. It fits pretty well with the growing body of evidence that trauma makes you ill. I feel bad that mental illness is so stigmatized that many of the affected women and their family don't believe it's possible that they have a mental illness.
posted by Snarl Furillo at 12:50 PM on March 8, 2012


I think Ms. Horn is talking about the fact that Ms. Brockovich and her crew were not allowed to take a soil sample, not about the existence of any soil analysis at all.
posted by muddgirl at 12:52 PM on March 8, 2012 [1 favorite]


saulgoodman: not sure I understand your question. Is someone suggesting that people aren't upset, or that the Batavian isn't running online polls?
posted by lodurr at 12:52 PM on March 8, 2012


Why is this bit even in the NY Times article if it isn't true?

What? It is true. They did not let Erin Brokovich take soil. The mother is truly angry about that. That does not suggest or imply that no soil was tested.

what is this school/it's student culture doing to put its girls under so much stress?

If that question means why is this happening at this school, I'm not sure that's really the right question to ask. Mental illnesses, for the most part, do not have discreet causes such that X type of stress leads to Y type of reaction. It's much more useful to think that there is a general reservoir in some folks of mental distress, and socially constrained ways in which that distress then manifests. Anorexia, for example, is very prevalent among stressed out your women, young women who have experienced trauma, in other words, young women like these who are afflicted by conversion disorder. The environment need not be extraordinarily stressful, it can be normally stressful (which is stressful enough), and young women predisposed to increased distress from that stress may begin to exhibit any number of a range of symptoms in response.
posted by OmieWise at 1:00 PM on March 8, 2012 [1 favorite]


If that question means why is this happening at this school, I'm not sure that's really the right question to ask. Mental illnesses, for the most part, do not have discreet causes such that X type of stress leads to Y type of reaction.

Fair enough, but it still seems odd there's such a pronounced clustering effect here. While I appreciate these phenomena can be transmissible, it seems more than a little unsatisfying to be left with, "Eh, these things just happen this way," for an explanation. I also think it's wise to consider the possibility that something unique to the student culture at this particular school is aggravating the level of social tension/background stress.

also, though I meant to cover this kind of thing once and for all on my profile, the former copy editor in me can't stand it: i meant "its" not "it's."
posted by saulgoodman at 1:16 PM on March 8, 2012


Fair enough, but it still seems odd there's such a pronounced clustering effect here. While I appreciate these phenomena can be transmissible, it seems more than a little unsatisfying to be left with, "Eh, these things just happen this way," for an explanation.

Well, I'm saying something a bit more involved than that. I'm suggesting that if, say, 20% of students are experiencing significant mental distress, and if that distress is manifesting itself in specific symptoms of a mental illness, you would expect that kids who had previously been showing symptoms of an eating disorder, or a mood disorder, are now showing symptoms of conversion disorder. In other words, conversion disorder is occupying the ecological niche that is normally occupied by other disorders. That's what transmissability means in this context. It is not that mental illness is catching, but that some ways of expressing mental distress are more favored than others. The overall disease burden has likely changed very little.* At least according to my theory about how these things work, which is based on a grounding in the history of the expression of mental illness.

*There is likely also some suggestibility at work, such that people who previously may have had some distress but no symptoms of a disorder, could now be diagnosed with conversion disorder. But that's likely a small effect. These are not people faking, or becoming spontaneously ill, these are people exhibiting a new understanding about how to appropriately express their distress.
posted by OmieWise at 1:33 PM on March 8, 2012 [4 favorites]


It'd be interesting to see if the data bore out that conjecture, OmieWise.
posted by saulgoodman at 1:37 PM on March 8, 2012


I agree, but it would be really hard to study.
posted by OmieWise at 2:21 PM on March 8, 2012


Going back to an early comment, and perhaps just to play devil's advocate (heh): I thought it was pretty well established that a major cause of the Salem Witch Trials episode was ergot poisoning in the town's rye supply?
posted by eviemath at 2:38 PM on March 8, 2012


When I was young, I had a relative with insoluble lower back pains, leg cramps, and selective mutism. Later, I heard from someone else -- an MD in my family, although not his doctor -- that he had finally been diagnosed with conversion disorder; I asked what "conversion disorder" meant. The answer was, "It means there's nothing wrong with him."

The afflicted relative was not a trustworthy person, and he was widely disliked for solid reasons. Still, I wish to hell that I hadn't been told that about conversion disorder. I believed it for years -- up until very recently, when I had long since educated myself about other disorders. I should have been a lot kinder.
posted by Countess Elena at 2:59 PM on March 8, 2012


O/T.. I haven't reviewed the links yet but the mass hysteria part reminded me of the weird stories behind the 'dancing mania' over a couple of centuries in Europe, particularly in Taranto in Italy (tarantism).
posted by peacay


I thought of that connection, too, but I think those dancing manias are more likely to represent the progress of a new strain of strep across Europe than pure mass hysteria (there's no reason strep couldn't potentiate mass hysteria with specific content, of course, depending on its antigenic profile, perhaps).

A strain that has antigens and effects in common with the streptococcus that causes Sydenham's Chorea, which is more common in females than males, interestingly, usually presents before age 16, and has some resemblance in symptoms to accounts I've read of the symptoms of the girls of LeRoy:
Sydenham's chorea is characterised by the acute onset (sometimes a few hours) of neurologic symptoms, classically chorea, usually affecting all limbs. Other neurologic symptoms include behavior change, dysarthria, gait disturbance, loss of fine and gross motor control with resultant deterioration of handwriting, headache, slowed cognition, facial grimacing, fidgetiness and hypotonia.[6][7] Also, there may be tongue fasciculations ("bag of worms"), and a "milk sign", which is a relapsing grip demonstrated by alternate increases and decreases in tension, as if hand milking.[8]
It's especially interesting to me in this regard that, according to the accounts I've read, the crowds of maniacal dancers were notable for the number of women in an advanced state of pregnancy they contained, because Sydenham's Chorea can resurface during pregnancy as chorea gravidarum.

A few years ago, another mystery illness-- the illness that afflicted the sleepers of Oliver Sacks' book Awakenings, and had swept the world in the wake of the great Spanish Flu Epidemic-- was fairly persuasively attributed to another another form of strep, diplococcus.

Diplococcus is an endemic infection among domesticated cattle, and is often the infectious agent responsible for mastitis.

LeRoy is in a rural area with two nearby feedlots; the last two years there before the outbreak had been the rainiest on record (I read); and the girl's softball field was built on reclaimed swampland within the last few years (I also read).

In addition, I read an account (I have no idea how accurate) claiming that the parents of at least one of the afflicted girls claimed that, despite the assertions of "neurologists" to the contrary, no tests at all had been performed on their daughter, but they may not have realized that perhaps the neurologists in question only required the test of a few minutes conversation with the girl to know for an absolute fact that she was suffering from a conversion disorder.

If they wanted to find evidence of the kind of thing I'm talking about, they could have tested for antibodies to the basal ganglia.
posted by jamjam at 3:33 PM on March 8, 2012 [1 favorite]


This is a great story. I've been covering it for a while, looking at the connections with earlier outbreaks of mass psychogenic illness and the claims about PANDAS. An interview with a leading expert on MPI, who actually induced it in experimental conditions (in a very mild way), regarding how to treat it is here.

PANDAS is real and fascinating, but it doesn't typically affect clusters of people and affects more boys than girls and also, evidence of strep wasn't found in all the girls. So, the odds of PANDAS caused by *two* different infectious sources in one place in teenage girls at the same time basically are tiny. Strep outbreaks typically don't cause PANDAS clusters (none has ever been reported) because the genetics that makes the body react to strep in this way is not that common, thankfully.
posted by Maias at 3:51 PM on March 8, 2012 [4 favorites]


One simple soil test would kill the debate.

I seriously doubt one simple soil test, can settle the debate any more than a birth certificate can convince birthers that Obama is a citizen. This is the level of the debate here.
posted by 2N2222 at 4:32 PM on March 8, 2012 [1 favorite]


I thought it was pretty well established that a major cause of the Salem Witch Trials episode was ergot poisoning in the town's rye supply?

Erm...Ergot poisoning is suspected / theorized to be the cause of some of the *victims* coming forward and saying that witches had afflicted them. It doesn't, however, explain why a town full of (seemingly) rational people would start listening to kids' stories and hang a bunch of people.
posted by ShutterBun at 5:07 PM on March 8, 2012 [1 favorite]


Here's two fun anecdotes for people unfamiliar with Conversion Disorder:

Neurologists, as a type, are not doctors who I would describe as "loosey-goosey" with their examination and description of illness. The specialty tends to attract detective types, since there is such a plethora of places for neurological disorders to arise and way for them to present. One neurologist I know, when examining a new patient with Residents, would write down an mnemonic for differential diagnosis (see explanation here) and make them go through every letter and list at least one or three possible causes for each category before they would entertain a suggestion of Conversion Disorder as the diagnosis. Now all teach docs love a good differential diagnosis, but neurologists and House are the only ones I knew who would drag it out to take an hour of rounds.

Secondly, patients with conversion disorder do get treatment with rehab, but inpatient rehab facilities have a policy allowing only one Conversion Disorder patient at a time. Apparently CD is contagious enough that two patients will continuously 're-infect' each other.
posted by midmarch snowman at 5:22 PM on March 8, 2012 [2 favorites]


I seriously doubt one simple soil test, can settle the debate any more than a birth certificate can convince birthers that Obama is a citizen. This is the level of the debate here.

Well, to be fair to the skeptics, there is a long history of official abuses and coverups--often even encouraged and facilitated by medical professionals--that might make some degree of skepticism of official accounts slightly more reasonable than the half-serious claims of partisan fanatics who without any prior precedent or evidence insist on pretending to believe the president is a secret muslim terrorist (despite his demonstrated knack for killing prominent Muslim terrorists).
posted by saulgoodman at 6:36 PM on March 8, 2012 [1 favorite]


(But point granted, although I'd point out it's actually quite reasonable and understandable for the parents to have very strong--possibly even somewhat irrational--feelings in a case like this, and no doubt, they are sincerely motivated by concern for the well-being of their children, not "playing politics" as some tasteless hack like Rush Limbaugh might want to portray it. That said, I'm with you in spirit, even if I don't share your sneering contempt.)
posted by saulgoodman at 6:49 PM on March 8, 2012


Brockovich's firm: Groundwater not contaminated by trichlorothene

posted by vitabellosi at 9:05 PM on March 9, 2012 [1 favorite]


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