Toxins or Hysteria -- the teens of Leroy, New York are haunted by tics

The story of the mystery ailment in Leroy, New York, where more than a dozen teenage girls have been afflicted by uncontrollable tics already has some lessons – but mostly of them are not the ones you’re likely to hear about.

Can you believe that many of the sick teens first learned of their supposed psychiatric diagnosis while watching television?

I my opinion, far too many doctors (and other media mavens) have been weighing in publicly about the troubles of 16 teenage girls they have don’t even know and have never even met.

Opinions abound over whether what afflicts them is a neurological illness or simply an example mass-contagious hysteria.

After interviewing the main attending doctors who have been treating the teen, as well as two of the patients themselves, I have my own cautious conclusion. But the real news is that at least some of the young women say they’re getting better, thanks to treatment – even though it’s still hard to be sure what’s ailing them.

In fact, doctors often have to “treat the symptoms” while we try to make a more informed diagnosis.

For the record, I’m inclined to disagree with the latest “MDs on the ground”: As I see it, the most likely explanation for the teens’ troubles remains psychiatric.

The school the teens attend is small and all the young people there know each other.

Rumors spread quickly after the first teens fell ill. The tics or involuntary muscular movements they experienced weren’t typical for any known condition.

Both of the 16-year-olds I interviewed seemed vulnerable and worried.

In one case, especially, the girl had been functioning well until the day when she was beset by violent tics which affected her shoulder. She saw Dr. Jennifer McVige at Dent Neurological Institute in Buffalo, but her condition persisted despite medication, and soon she was unable to attend school.

Enter Columbia-trained Dr. Rosario Trifiletti -- a child neurologist in New Jersey, and an expert in PANDAS which is also know as Pediatric Auto-immune Neuropsychiatric Disorder.

Trifiletti visited nine of the girls in Leroy, and is treating them now with simple anti-inflammatory drugs such as ibuprofen and antibiotics.

Trifiletti told me that he believes a chemical toxin in the environment around Leroy, known as TCE or trichloroethylene, may have predisposed these teens to PANDAS, which is then triggered by a bacterial infection such as strep. But, again, what important to note here is that the physician's treatment doesn’t depend on that belief.

I’m not convinced.

I believe Dr. Trifiletti is too reliant on blood-test results and on speculation about their significance.

TCE leeched into the environment around Leroy after a train accident some 40 years ago and it has not been known to cause these kinds of problems.

The two girls I met are very sensitive to stress.

In once case, her mother of one of the girls told me that she has “tics” when she observes others having them, which also seems psychological.

In the case of conversion hysteria the symptoms are very real – psychological stresses lead to physical manifestations.

I didn’t personally witness any of the tics, but the girls’ descriptions and the video I’ve seen are not consistent with Tourette’s syndrome or any other neurological disorder.

In the end, whether this affliction is psychological or physical, the problem is real, and it is spreading.

Dr. Trifiletti is helping the patients and their families to cope, and this is a good thing. I think they are getting better because of his concern and caring -- a true placebo effect -- even if his diagnosis may be off the mark.

Trifiletti has a well-worn office, without a lot of bells and whistles. In contrast to those who presume to engage in “long-distance diagnosis,” he still represents old-fashioned doctoring in the best sense of the word.

Marc Siegel, M.D. is a professor of medicine and medical director of Doctor Radio at NYU Langone Medical Center. He is a member of the Fox News Medical A team and author of several books. His latest book is "The Inner Pulse; Unlocking the Secret Code of Sickness and Health."