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ENT involvement and orobuccal movements' disorders in Pandas patients: assessment and rehabilitations tools.
- Source :
-
European review for medical and pharmacological sciences [Eur Rev Med Pharmacol Sci] 2019 May; Vol. 23 (10), pp. 4110-4117. - Publication Year :
- 2019
-
Abstract
- Objective: PANDAS are known as the spectrum of autoimmune pathologies related to a previous or current infection by group A beta-hemolytic streptococcus (SBEGA), dealing with several neuropsychiatric manifestations that mainly affect pediatric age. The main features consist of behavioral disease or movement disease characterized by acute-onset, presenting especially through infant period or adolescence. Specific manifestations, occurring during the progression of the disease, are the presence of otorhinolaryngologic symptoms (ENT) and orofacial movement disorders associated with temporomandibular joint pain.<br />Patients and Methods: We enrolled 130 children (5-15 years) with a clinical diagnosis of PANDAS between 2012 and 2018. Participants were assessed using ENT specific parameters, PSG to examine respiratory disorders and conventional audiological evaluation. Descriptive and comparative statistical analyses were performed with a control group of 51 healthy patients.<br />Results: The prevalence of ENT symptoms associated was significantly detected in 88 patients of 130 in Group A (relative frequency (%) 67.6; p=0.041) and in 51 patients of 130 in the control Group B (relative frequency (%) 39.2; p=0.063). In relation to prevalence of SDB, 54 subjects have presented nocturnal respiratory obstructive symptoms from mild to severe (relative frequency (%) 61.3; p=0.033) vs. 20 patients of Group B (relative frequency (%) 39.2; p=0.055). The obstructive severity average type was correlated to the consensual adenotonsillar development (size 3-4), (relative frequency (%) 45.4; p=0.047). The audiological deficits found were mostly of transmissive type with OME correlated and linked to the presence of occasional episodes of AOM. The four PANDAS patients who presented orobuccal dystonia (relative frequency (%) 4.54; p=0.091) achieved an improvement of the algic symptoms through the exercises of self-rehabilitation.<br />Conclusions: Findings from our study show that respiratory diseases, characterizing a group of patients with pandas, are the direct consequences of the malformed or hypertrophic condition and suggesting in these conditions surgical therapy as an approaching tool.
- Subjects :
- Adolescent
Autoimmune Diseases diagnosis
Case-Control Studies
Child
Child, Preschool
Female
Humans
Lung Diseases, Obstructive epidemiology
Lung Diseases, Obstructive physiopathology
Male
Movement Disorders diagnosis
Obsessive-Compulsive Disorder epidemiology
Otorhinolaryngologic Diseases epidemiology
Otorhinolaryngologic Diseases physiopathology
Pain etiology
Prevalence
Severity of Illness Index
Streptococcal Infections complications
Streptococcal Infections rehabilitation
Streptococcus pyogenes isolation & purification
Temporomandibular Joint pathology
Autoimmune Diseases complications
Autoimmune Diseases rehabilitation
Dyskinesias physiopathology
Movement Disorders etiology
Obsessive-Compulsive Disorder complications
Obsessive-Compulsive Disorder rehabilitation
Streptococcal Infections microbiology
Subjects
Details
- Language :
- English
- ISSN :
- 2284-0729
- Volume :
- 23
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- European review for medical and pharmacological sciences
- Publication Type :
- Academic Journal
- Accession number :
- 31173280
- Full Text :
- https://doi.org/10.26355/eurrev_201905_17912