Singer --- recent news/thoughts

[smartyjones]

Hello old friends! anyone have any recent news and/or thoughts about old pal Harvey Singer? I have a friend whose son has been referred to him. She was mentioning he was referred to a neurologist from Hopkins, she almost fell over when I guessed who it was.

Thanks!

[Mom23boys]

He is still firmly in the camp of PANDAS is a controversial diagnosis, I think . . .

[dasu]

It appears that he graduated from the PANS into CANS and now into an agnostic stance from this publication dated July 2015 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4502346/. That said perhaps his clinical practice differs from his scholarly disbelief.

 

I am glad I read this - whether or not I agree. One statement was that a study by Leckman et al found exacerbations that feature tics and OCD do not also come with other symptoms like ODD and anxiety. (From my sample size = 2 kids, that is untrue; however we do note that underlying issues such as ). A second less debatable statement was made that PANDAS can be divided into two groups PANDAS-choreiform and PANDAS-OCD/tics.

... two differing subgroups of children fulfilling the original proposed
criteria for PANDAS have been reported: 1) the original cohort,
displaying choreiform piano-playing movements (PANDAS-choreiform),
and 2) a PANDAS-chronic tics and OCD cohort that includes
children with at least two prior acute fulminant episodes of tics or
OCD in a temporal association with a GABHS infection, but lacking
piano-playing movements.6 ... PANDAS-choreiform cohort has
biomarkers very similar to Sydenham’s chorea (elevated antidopamine
1 receptor (D1R) and anti-dopamine 2 receptor (D2R)
immunoglobulin (Ig)G levels and possibly elevated anti-lysoganglioside-
GM1), whereas the PANDAS-chronic tics and OCD group has
normal levels of antibodies to tubulin and D2R, and control groupdependent
alterations of anti-D1R and lysoganglioside-GM1,

Edited November 11, 2015 by dasu

[Mom23boys]

The Leckman study actually tried to correlate worsening of ocd/tics with strep. They took kids diagnosed with PANDAS and non PANDAS with tics/ocd (TS kids) and repeatedly tested them for strep. There was zero correlation in the PANDAS kids between worsening symptoms and strep infections. Interestingly, several of the kids did show a correlation, but those were in the TS group.

 

If you read the attached article, he basically debunks the diagnostic criteria for PANDAS. Even the 5 children that the original authors say met the criteria, Singer argues are problematic. He did come up with CANS, which is sort of a kitchen sink diagnosis from what I have heard it called.

 

I would not tell your friend to expect a sympathetic ear if she is going for acute onset of ocd/tics/anxiety that she suspects may be related to a strep infection