That Erin Brockovich is getting a lot of media attention for investigating the mysterious symptoms that are affecting 15 teens in a small town in western New York shouldn't be surprising. It is an interesting case.
Most of the teens have been experiencing motor and verbal tics since October without an answer that is satisfying to all of the parents.
No one likes a medical mystery (unless it has already been solved) and the area seems to have a chemical history, including a company that made rat poison and a train derailment that led to a chemical spill 41 years ago.
Could chemicals that contaminated local well water have caused the mysterious symptoms? It sounds reasonable, but why wouldn't they have caused symptoms in people who actually drank the well water before carbon treatment units were installed in 1971 and again in 1991?
Interestingly, the drinking water for Le Roy comes from the Monroe County Water Authority, which tests for, but hasn't found any trichloroethene, the industrial solvent that contaminated groundwater in the area near the train accident.
The teens were diagnosed with conversion disorder - which is typically a diagnosis of exclusion, made after you have eliminated all of the other likely possibilities. Did the doctors at the private clinic, which seems mostly geared towards treating adult patients, meet the criteria for making a diagnosis of conversion disorder?
According to ABC News, doctors have ruled out:
- PANDAS - an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, a condition in which children develop worsening tics and OCD-like symptoms after strep infections
- Gardasil - many people were quick to jump on the HPV vaccine as the cause, as most the affected teens were girls, but it turns out that many of the girls did not receive the vaccine
- environmental toxins - although many people think the testing that was done was grossly inadequate
Routine tests likely also ruled out infections, drugs, and seizures, etc.
So is a diagnosis of conversion disorder or mass hysteria that far fetched? Most people will be surprised to learn that a group of 10 students at a small high school in North Carolina were diagnosed with mass hysteria (another name for conversion disorder) at the start of the 2002 school year. Twelve students, 11 girls and 1 boy, were originally evaluated after developing episodes that resembled seizures - which they were having for four months. It was determined that the boy was indeed having seizures and one of the girls was suffering from postural hypotension, which can lead to fainting. The other 10 girls were diagnosed with mass motor hysteria, which went away after the students were separated over Christmas break.
Some interesting lessons from the North Carolina episode include:
- fragmentation of care can lead to delayed recognition
- delayed recognition of mass hysteria can lead to unnecessary procedures and treatments
And perhaps most importantly, "reluctance of some families to consider psychological explanations for the episodes" can lead to delayed diagnosis.
Other episodes of mass hysteria include:
- 15 teen female students at an Alaska high school who were transported to the ER because they were ill appearing and had a variety of symptoms after a possible (later undetected) toxic inhalation exposure at a junior high school.
- 75 children in 1983 who developed a headache, dizziness, abdominal pain, and nausea after a women fainted during a Catholic mass in Cincinnati.
- 95 students and 3 teachers at a school in Alabama (the Berry outbreak) who developed itching, headache, cough, weakness, sore throat and other symptoms in 1973 after seeing two school girls with severe itching in the hallway.
- 17 children and 5 adults who were taken to emergency rooms in 2009 while attending church after a child fainted during the mass in Southern California. While carbon monoxide poisoning was first suspected, further testing was normal at the church and from all of the patients.
- 26 children in Belgium were taken to a hospital in 1999 after drinking Coca-Cola that was thought to be contaminated, but was eventually linked to a harmless smell on some of the cans and mass sociogenic illness, but only after causing symptoms among many other children.
And an article in the Journal of Pediatrics (1980), "Diagnosing hysterical conversion reactions," describes 105 children with conversion reactions that were diagnosed over a 3 year period at Children's Hospital Medical Center in Cincinnati. They found that many of their patients had unresolved grief reactions, a clinically depressed parent, and/or significant family communication problems. The authors suggested that "Expanding the history and physical examination to include an evaluation of family interactions and personality diagnoses can be helpful in" accurately diagnosing conversion reactions.
Of course, we don't use the term mass hysteria anymore. The medical diagnosis is conversion disorder and either way, one should be clear that a diagnosis of conversion disorder doesn't mean that the person is faking the symptoms.
Could the teens in Le Roy have conversion disorder? The "Stern: Massachusetts General Hospital Comprehensive Clinical Psychiatry" textbook suggests that to make a diagnosis of conversion disorder:
- negative evidence is critical
- you should have a meticulous review of the evidence
- it requires detective work and close observation of the patient
- you should have confidence in the diagnosis
- the diagnosis cannot rest only on the absence of organic disease
That the doctors are offering to do more tests suggests they may not have confidence in their diagnosis.
Could the the teens in Le Roy be having symptoms that are caused by fracking, nearby natural gas wells, some type of chemical, pesticide, or environmental hazard? I don't know, but I'm not sure that someone like Erin Brockovich is the best person to get involved. Why not someone from a nearby Children's Hospital, state health department, the EPA, CDC, and/or the NIH, so that all of the students can be evaluated by the same experts?
Hopefully, now that the NIH is getting involved, we will get some answers that will satisfy everyone.
If the symptoms are caused by mass hysteria, which are triggered by stress, reports that "national environmental and health groups are beating a path to LeRoy" likely aren't going to make things any better.
You said: ” I don’t know, but I’m not sure that someone like Erin Brockovich is the best person to get involved. Why not someone from a nearby Children’s Hospital, state health department, the EPA, CDC, and/or the NIH, so that all of the students can be evaluated by the same experts?”
If that approach had been followed when Brockovich helped the chromium 6 as the cause of the famous cases poisoning in the small town of Hinkley.
Where were the experts from “a nearby Children’s Hospital, state health department, the EPA, CDC, and/or the NIH” then?
Do you seriously think attitudes have changed since then?
Jim Moss
Gainesville
Florida
Just Google “1971 New York train derailmaent” and you will find some very disturbing info on the spill in Leroy and the rediculous follow up and countermeasures. Once again the pubic’s safety was not and is not taking priority over “oh we don’t want to get sued” go figure.
How many toxic spills have occurred in US since 1970? Is Brokovich searching for another movie?
It seems as if the parents of hysterical teen-agers are becoming hysterical
Could this be caused by Lyme disease?
None of these symptoms are consistent with Lyme disease.
And Lyme disease does not cause ” outbreaks” like this.
To address the comment about Erin Brockovich (or Dr.Drew HLN) becoming involved “maybe not being the best thing”, I would argue that without the national media spotlight – the EPA would have continued to drop the ball in this case. LeRoy is victim to the largest TCE spill in the United States and monitoring of the situation (and clean-up) has been dismal at best. Jumping to a psychological diagnosis without proper investigation and ruling out of environmental and other influences borders criminal. Why are doctors so quick to use the catch-all “it’s psychological” when they don’t understand something. EPIC FAIL
“Why are doctors so quick to use the catch-all “it’s psychological” when they don’t understand something.”
I would hardly say that the pediatric neurologist who diagnosed the teens made a quick diagnosis. In addition, local health department and state health department were involved and they talked with experts at Columbia and the CDC. I’m sure that all didn’t happen overnight.
Conversely, it seems like many people are even quicker to give them a catch-all diagnosis of having side effects (vaccines?), autoimmune or infectious conditions (PANDAS, Lyme disease), or exposure to chemicals (fracking, the chemical spill).
Yes there was a chemical spill, but what is a good mechanism for why it is causing these kids to have symptoms now?
And why did two teens from another town 250 miles away get similar symptoms? Sure they were softball players, but they didn’t play on the LeRoy school fields. They simply stopped for dinner in LeRoy last summer while on their travel softball team.
This has Lyme disease written all over it. Parents of these children, do make sure a western blot is run and that its looked over by a doc who knows a thing or two about Lyme disease. You don’t needs all the bands to have Lyme. Certain specific ones. Coninfections are very possible. My child had the same symptoms to a much smaller degree. It was Lyme. Lyme is huge in that area of upstate NY and the number of cases Ny this past year have sky rocketed. Please someone help these parents!
Has anyone checked out Aluminum it causes sever trembling and damage to the nervous system and Barium causes tremors.
People say Chemtrails contain both chemicals.
Doctors are not environmental experts and cannot rule out environmental illness unless they have gone through the school/town with environmental experts, tested, reviewed MSDS sheets-chemical/pesticide/fungicide/herbicide use etc. Was fungicide used in the building before testing? I do not buy the Mass Hysteria diagnosis because all avenues have not been explored. The school department not cooperating is a classic example of some kind of guilt. Protect the administration…not the kids…lust like the admin at Penn State and our school here in Westborough Ma. Thank god our town cleaned up their act and our children are safer now. If the school wants to really put this to rest and move forward they need to work together with the community members and have a transparent investigation immediately.
“The school department not cooperating is a classic example of some kind of guilt. Protect the administration.”
Because they kept unauthorized people off school grounds doesn’t mean that they are trying to protect the administration.
The school had another meeting today with the parents and the community and they announced additional environmental testing, even though the previous testing gave a “good indication that there was no environmental factors emanating in this building.” And while there were some critics at the meeting, there were reportedly just as many supporters of the school.
If you don’t buy the mass hysteria diagnosis, what is your theory for this group of kids was exposed to a chemical/pesticide/fungicide/herbicide and had these symptoms, which includes kids that live 250 miles away and were only in LeRoy for a brief time? Even in the Erin Brockovich movie, I think she had a theory for how the people were harmed – chromium 6 getting in the water supply.
And why are there more cases now? One big theory was that the large amounts of rain in the area last fall stirred up chemicals and caused everyone to get sick. And now?
Eliminating other possibilities is one of the keys to making a diagnosis of mass hysteria or conversion disorder. It is important to keep in mind that the pediatric neurologist who made this diagnosis didn’t do it alone. She was aided by local and state agencies, in consultation with federal agencies, and the testing that the school did.