Health Team

Rare strep throat complication can cause OCD behaviors, tics

The parents of a 10-year-old Raleigh boy began noticing strange behavior in their son about a year ago, but had no idea that it could be the result of strep throat.

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DURHAM, N.C. — The parents of a 10-year-old Raleigh boy began noticing strange behavior in their son about a year ago but had no idea that it could be the result of strep throat.

Chris Martin complained of stomachaches and restlessness, his parents said.

"He would, all of the sudden, just blank out and become unresponsive," Amy Martin said. "He was having, just, tics and OCD behavior like crazy."

Chris had increasing anxiety, and his school work began to suffer.

"He'd ask me to take him to the hypnotist so that he could forget his bad thoughts," Tim Martin added.

Chris never had a fever or sore throat, but because of the neurological complications, doctors eventually gave him a strep test, which came back positive. 

Left undiagnosed and untreated, strep throat can result in scarlet fever, rheumatic heart disease or in rare cases, pediatric autoimmune neuropsychiatric disorder associated with streptococcus, or PANDAS.

"The PANDAS syndrome is characterized by the rapid and explosive onset of two major psychiatric symptoms – obsessive compulsive disorders and tics," said Dr. Richard D'Alli, a pediatric psychiatrist at Duke University Hospital. 

PANDAS occurs is less than 1 percent of children with strep throat. If a child suddenly begins showing obsessive compulsive behaviors and tics, such as repeated blinking or scratching, parents should ask their doctor for a strep test.

Antibiotics and cognitive behavior psychotherapy are required to treat PANDAS. In some cases, doctors also prescribe anti-depressants.

Chris takes the medications while he is in school.

"It helps me to focus more in class," he said. "(And) just stops the stomachaches."

In the year since his diagnosis, Chris is progressing. 

"I'm feeling less worried, sometimes I get a little timid," he said.

"My hope is that he will be normal and be just fine," Amy Martin said. "That's my hope."

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