Abstract Details

Title Le Roy: Diagnosing Mass Psychogenic Illness

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) Behavioral and Cognitive Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 043

Objective Present clinical data from a rare case of Mass Psychogenic Illness (MPI) in LeRoy,NY involving movement disorders (tic-like movements). Evaluate laboratory, neuroimaging, and electrophysiology results.

Background Between October 2010 and September 2012, 19 people were involved in a case of MPI; 15 evaluated at our clinic. Evaluation and treatment involved laboratory tests, MRI/CT, and EEG. Diagnosis was made using DSM IV criteria for MPI, which is a simultaneous occurrence of related signs or symptoms with a psychogenic basis in multiple individuals as a group. This illness is defined under a type of conversion disorder; the alteration or loss of a physical function suggestive of physical disorder with expression of underlying psychological conflict. There is no standardized testing to diagnose MPI or conversion disorder; it is a diagnosis of exclusion.

Design/Methods Retrospective review of charts included physical examination and a series of diagnostic testing to rule out other neurological or medical conditions which could have caused the symptoms. Tests were individualized per patient presentation; not all received the same testing.

Results Laboratory studies included ASO, ESR, TSH, heavy metals, tox screen, Ceruloplasmin, ANA, CBC, CMP, Lyme, and Mycoplasma. All tests were normal aside from minor abnormal measures of TSH (4/14; 1 low, 3 elevated), ESR (2/14 elevated), ANA (2/14 elevated), and Mycoplasma IgM (2/14). Neuroimaging was normal aside from 2/14 with nonspecific findings unrelated to symptoms. No abnormalities found in EEG.

Conclusions There was no consistent abnormality to suggest a uniform organic cause for the movement disorder, therefore supporting the diagnosis of MPI. All patients did recover.

Authors/Disclosures
Jennifer W. McVige, MD, FAAN (Dent Neurological Institute) PRESENTER	Dr. McVige has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Theranica. Dr. McVige has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. McVige has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan/AbbVie. Dr. McVige has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amgen. Dr. McVige has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biohaven. Dr. McVige has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Eli Lilly. Dr. McVige has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Teva. Dr. McVige has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Neurelis. The institution of Dr. McVige has received research support from Amgen. The institution of Dr. McVige has received research support from Eli Lily. The institution of Dr. McVige has received research support from Biohaven. The institution of Dr. McVige has received research support from Lundbeck. The institution of Dr. McVige has received research support from Dent Family Foundation. Dr. McVige has a non-compensated relationship as a Neurology Board with UCNS that is relevant to AAN interests or activities. Dr. McVige has a non-compensated relationship as a Board Exam Board Member with ABPN that is relevant to AAN interests or activities.
	No disclosure on file
Said Shukri, MD (University of Michigan)	Mr. Shukri has nothing to disclose.
Ahmad Munir	Ahmad Munir has nothing to disclose.
Laszlo Mechtler, MD, FEAN, FASN, FAHS, FAAN (Dent Neurologic Institute)	Dr. Mechtler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Impel Pharma. Dr. Mechtler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Mechtler has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Genomate Health. The institution of Dr. Mechtler has received research support from The Harry Dent Family Foundation, Inc. The institution of Dr. Mechtler has received research support from Alpheus medical. The institution of Dr. Mechtler has received research support from Shiratronics. The institution of Dr. Mechtler has received research support from Abbvie Inc. The institution of Dr. Mechtler has received research support from Amgen. The institution of Dr. Mechtler has received research support from Eli Lilly Company. The institution of Dr. Mechtler has received research support from H. Lundbeck HS. The institution of Dr. Mechtler has received research support from Pfizer. Dr. Mechtler has received personal compensation in the range of $100,000-$499,999 for serving as a Ownership interest with Neurology Practce Consortium GPO. Dr. Mechtler has a non-compensated relationship as a Board member with International Headache Society that is relevant to AAN interests or activities.
Sarah A. Mangold, DO (Nationwide Children's Hospital)	Ms. Mangold has nothing to disclose.

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