A 36-year-old nurse practitioner has been diagnosed as the first adult to have the mysterious Tourette-like illness that has spread across a rural New York town.



Marge Fitzsimmons, who works with developmentally disabled patients and has no immediate ties to the town's high school at the centre of the outbreak, has had to stop going to work because her body tics and twitches have gotten so severe that she can no longer work with her patients.



Details of her condition emerged today as researchers offered a new explanation for the strange symptoms that have been diagnosed in 14 teenage girls and one teenage boy.



Doctors have singled out the possibilty of paediatric acute-onset neuropsychaitric syndrome, or PANS, as a solution.

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Life interrupted: Marge Fitzsimmons' speech was cut off during an interview because of the tics

However, the new addition of an adult to the list of victims is likely to cast doubt on the theory that the outbreak is caused by a condition prevalent in children.

'It started out with sudden head jerks in the middle of October. The motor tics wouldn't stop, and the vocal tics started, and I went to one of the bosses and said I have to go,' Ms Fitzsimmons told NBC News.



'When it first started I thought maybe I'm going crazy.



'As an adult, I can't imagine these teenagers going through this and for anyone to think that they're faking it at all. Try living a day in their shoes.'

Lori Brownell, 16, posted a video on YouTube showing the Tourettes-like symptoms she has suffered since August. She is one of 15 at LeRoy High School in New York State who have developed the mystery condition

School scandal: Eighteen Le Roy High School students reported a mysterious outbreak of spasms and seizures

Researchers are now looking into a new explanation – that infections caused by bacteria or viruses can cause also infect the brain, leading to onsets of Tourette’s and obsessive-compulsive disorder.

News of the adult case comes after fifteen teenagers were of the affected who attend Le Roy High School in Genesee County, New York State. Only one boy has been affected, the other 14 sufferers are girls.

According to the Scientific American, some experts now believe that the upstate New York teens may have paediatric acute-onset neuropsychiatric syndrome, or PANS.

POSSIBLE CAUSES:

Medical Researchers are now looking into a new explanation – that infections caused by bacteria or viruses can cause also infect the brain, leading to onsets of Tourette’s and obsessive-compulsive disorder. Doctors from the Dent Neurological Institute have tested the teenage victims for paediatric acute-onset neuropsychaitric syndrome, or PANS, which they singled out as a solution. One specialist, Dr Rosario Trifiletti, has already ruled this diagnosis out, however, saying instead that it is a case of mass hysteria and conversion disorder or walking pneumonia though that is extremely uncommon over the age of 11.

Psychological The Centers for Disease Control concluded that Morgellons - a disease that causes patients to sprout painful sores - exists only in the patients' minds, much like early hypotheses that the Le Roy teenagers suffered from 'mass hysteria.' School administrators do not agree, and have insisted it is not a case of mass hysteria and that none of the girls are making the illness or symptoms up. They would not disclose any other possible explanation.

Environmental The geographic specificity of the case and rapid spread piqued the interest of environmental campaigner and lawyer, Erin Brockovich, who made her name from a case involving a cancer-causing oil leak in California. She has suggested that a chemical spill from a train derailment in the 1970s near the site of the school may be the cause.

Critics have said that Brockovich's involvement will only serve to increase the mass hysteria.



The disease, once called PANDAS (paediatric autoimmune neuropsychiatric disorder associated with streptococcal infection), first manifested in children who developed OCD after having a bout of strep throat.

According to WIVB.com, doctors from the Dent Neurological Institute have met with some of the students.

Dr Rosario Trifiletti will be running tests for PANS, the results of which will be ready in one to two weeks.

He is a specialist in PANDAS and says walking pneumonia may be to blame, though the disease is extremely rare in patients over 11, as WGRZ reported .

The neurologist who has been treating the teenagers ruled out PANDAS soon after examining them and diagnosed them with conversion disorder.

Dr Trifiletti calls the diagnosis ‘absolute garbage,’ but adds if they do have a form of walking pneumonia, the infection is treatable with a simple antibiotic, like a Z-Pack.

Earlier last month, it was reported that 12 female students, who all attend Le Roy High School, in New York, had been diagnosed and were being treated for the unexplained illness.



That number has now risen to 15 teenagers and they are all reportedly suffering from verbal outbursts and involuntary twitches.

One of the teenagers affected, 16-year-old Lori Brownell, posted a video on YouTube discussing how her symptoms started last August and looking for help from anyone who might explain her condition.



She has not been able to attend school since the tics started and the seizures were becoming more frequent.



Thera Sanchez, 17, has had the symptoms for months and is constantly plagued by the immobilizing tics.



'I’ve had psychological treatment. They say this is stress induced. My psychological treatment …. That’s all they do is stress me out more,' she said.



Campaigning lawyer and environmental activist Erin Brockovich is now looking into the case.



In 1996, Brockovich fought and won a mass lawsuit for an estimated $333 million dollars against Pacific Gas and Electric, who allegedly contaminated drinking water in the town of Hinkley, California.

Examined: A team of Brockovich's non-profit team took samples from the area to test it for environmental toxins

Worrisome: The outbreak has turned national attention on the small upstate New York town

Brockovich, who was the inspiration for the eponymous film starring Julia Roberts, has already started investigating.





'We don’t have all the answers, but we are suspicious. They have not ruled everything out yet. The community asked us to help, and this is what we do.' -Erin Brockovich

She has suggested that a chemical spill from a train derailment in the 1970s near the site of the school may be the cause. She has sent scientists to collect soil samples around the high school.

'When I read reports like this that the New York Department of Health and state agencies were well-aware of the spill and you don’t do water testing or vapor extraction tests, you don’t have an all-clear,' she said.



According to a 1999 report by the U.S. Environmental Protection Agency, almost one tonne of cyanide crystals spilled to the ground in the derailment, along with 130,000 litres of trichloroethene.



The crystals were removed but the trichloroethene was absorbed into the ground.

Brockovich said she has received more than one hundred emails about the school.

Trying to understand: Thera Sanchez, 17, has had the mysterious symptoms for months and all of the treatments he has received have not helped to clarify any options for her or her family

She said: 'We don’t have all the answers, but we are suspicious. They have not ruled everything out yet. The community asked us to help, and this is what we do.'

Critics of Brockovich say that she is only hurting the cause by instilling more fear and mass hysteria in the area which is already filled with a bevy of questions and no answers.



Ms Fitzsimmons has lived in Le Roy all her life and is now worried that the threat that the illness is due to an environmental hazard in the area.

Crusading: Campaigning lawyer and environmental activist Erin Brockovich has taken up the case in Genesee County

School administrators would not disclose exactly what they think the cause is but have insisted it is not a case of mass hysteria and that none of the girls are making the illness or symptoms up.

A new study released by the Centers for Disease Control concluded that Morgellons - a disease that causes patients to sprout painful sores - exists only in the patients' minds, much like early hypotheses that the Le Roy teenagers suffered from 'mass hysteria.'



Sufferers of the mystery illness describe a variety of symptoms, including fatigue, erupting sores, crawling sensations on their skin and - perhaps worst of all - mysterious red, blue or black fibers that sprout from their skin.

Earlier this month, the school held a forum for concerned parents.



About 150 people attended, demanding to know what was wrong with the students.

Dr Greg Young, with the NYS Department of Health, said: 'I can assure you these children have all been seen by professionals that have come up with answers and they are all being treated and they're actually doing pretty well.'

He revealed that tics like this can be caused by a number of factors such as genetics, head trauma, drugs for ADHD and OCD and antihistamines.

Through tests over the last few months, they have been able to rule out a number of environmental factors, infections, illegal drugs and carbon monoxide poisoning.

But Brockovich believes New York officials might have prematurely ruled out environmental reasons for the teens having neurological symptoms.



According to WGRZ.com, the Centers for Disease Control in Atlanta has been consulted, along with Columbia University, as well as the Genesee County Health Department and the New York State Health Department.

