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Who Ya Gonna Call? A Multidisciplinary Review of Pediatric Neuropsychiatric Cases
Please join us for the live review of this session at 4:00 EST on Thu Nov 11:
https://clp21.secure-platform.com/a/solicitations/8/sessiongallery/schedule/items/122
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When patients are admitted due to altered mental status or behavioral changes, both Neurology and Psychiatry are consulted. The presentations sometimes do not clearly fit into Neurological or Psychiatric diagnoses while Pediatric teams are requesting the start of medication or treatment for resolution of the symptoms. The presenters will discuss a series of cases which have a strong psychiatric presentation and will discuss if the diagnoses are ultimately psychiatric, neurologic, or a bit of both. While the cases we are discussing will be adolescent and young adult cases, these cases will be applicable to the general Consultation-Liaison Psychiatrist. Timely diagnosis of these neurological conditions is important; delays in diagnosis can potentially misattribute the patient’s conditions to a psychiatric etiology, which may delay definitive treatment. Also, these diagnoses can present differently in pediatric cases than in adult cases. Thus, it will be important for psychiatrists to be able to recognize these conditions. Dr. Nanda will present the case of a teenage boy who became confused, paranoid, agitated, hypersexual, and hypersomnolent. He will discuss the boy’s disease course and discuss his neurological diagnosis, Kleine Levin Syndrome, and its management. Dr. Charoensook will discuss the case of a young woman who presented with anxiety and possible Avoidant Restrictive Food Intake Disorder (ARFID) before she received her definite neurological diagnosis. Dr. Charoensook will lead the participants through a discussion of whether her psychiatric symptoms are potentially related to her neurological diagnosis or if they occurred in parallel. Dr. Jacobson will describe a challenging pediatric patient who was ultimately diagnosed with Anti-NMDAR encephalitis. She will discuss the presentation of Anti-NMDAR encephalitis in children and adolescents, the key clinical features psychiatrists should be aware of, and psychiatric management. Dr. Santoro, a pediatric neurologist who specializes in neuroimmunology, will discuss neurocognitive regression in persons with Trisomy 21 and the neuroimmunologic component of this clinical entity. Down Syndrome Disintegrative Disorder is a relatively new condition characterized by developmental regression and subacute psychiatric symptoms, which may possibly be due to autoimmunity.
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When patients are admitted due to altered mental status or behavioral changes, both Neurology and Psychiatry are consulted. The presentations sometimes do not clearly fit into Neurological or Psychiatric diagnoses while Pediatric teams are requesting the start of medication or treatment for resolution of the symptoms. The presenters will discuss a series of cases which have a strong psychiatric presentation and will discuss if the diagnoses are ultimately psychiatric, neurologic, or a bit of both. While the cases we are discussing will be adolescent and young adult cases, these cases will be applicable to the general Consultation-Liaison Psychiatrist. Timely diagnosis of these neurological conditions is important; delays in diagnosis can potentially misattribute the patient’s conditions to a psychiatric etiology, which may delay definitive treatment. Also, these diagnoses can present differently in pediatric cases than in adult cases. Thus, it will be important for psychiatrists to be able to recognize these conditions. Dr. Nanda will present the case of a teenage boy who became confused, paranoid, agitated, hypersexual, and hypersomnolent. He will discuss the boy’s disease course and discuss his neurological diagnosis, Kleine Levin Syndrome, and its management. Dr. Charoensook will discuss the case of a young woman who presented with anxiety and possible Avoidant Restrictive Food Intake Disorder (ARFID) before she received her definite neurological diagnosis. Dr. Charoensook will lead the participants through a discussion of whether her psychiatric symptoms are potentially related to her neurological diagnosis or if they occurred in parallel. Dr. Jacobson will describe a challenging pediatric patient who was ultimately diagnosed with Anti-NMDAR encephalitis. She will discuss the presentation of Anti-NMDAR encephalitis in children and adolescents, the key clinical features psychiatrists should be aware of, and psychiatric management. Dr. Santoro, a pediatric neurologist who specializes in neuroimmunology, will discuss neurocognitive regression in persons with Trisomy 21 and the neuroimmunologic component of this clinical entity. Down Syndrome Disintegrative Disorder is a relatively new condition characterized by developmental regression and subacute psychiatric symptoms, which may possibly be due to autoimmunity.
Speakers
Janet Charoensook
Assistant Professor of Psychiatry and Pediatrics | CHLA/Keck School of Medicine
Dr. Janet Charoensook is a child and adolescent psychiatrist at Children's Hospital Los Angeles, where she works on the consultation-liaison service. She is an Assistant Professor of Psychiatry & the Behavioral Sciences and Pediatrics at the Keck School of Medicine of USC. She completed her Child and Adolescent Psychiatry Fellowship at the University of Southern California. She was chief fellow in her final year. She completed her general adult psychiatry residency at the University of California, Riverside.
Julienne Jacobson
Clinical Associate Professor Keck School of Medicine of USC | Direct C/L Psychiatry, Children's Hospital Los Angeles
Dr. Jacobson is the director of the C/L Psychiatry Service at Children's Hospital Los Angeles, and an associate professor of psychiatry and pediatrics at the Keck School of Medicine of USC. She is board certified in general psychiatry, child and adolescent psychiatry and consultation and liason psychiatry. Dr. Jacobson completed medical school, residency and fellowship training in Southern California at University of Southern California and Loma Linda University. Clinical interests include pediatric psychiatric syndromes such as delirium and catatonia, professional interests include teaching and mentorship of medical students and trainees.
Arjun Nanda
Child Psychiatry Fellow | University of Southern California/LAC+USC
Arjun is a native Vancouverite who attended medical school at St. George's University and completed residency at Case Western Reserve University (Metrohealth). Arjun is currently doing a child and adolescent psychiatry fellowship at the University of Southern California/LAC+USC Medical Center. His interests include consultation-liason psychiatry, neuropsychiatric disorders, transitional-age youth, first break psychosis, and perinatal psychiatry.
Jonathan Santoro
Assistant Professor of Neurology and Pediatrics; Director, Neuroimmunology and Demyelinating Disorders | CHLA/Keck School of Medicine
Dr. Santoro serves as the Director of Neuroimmunology and Demyelinating Disorders Program at Children’s Hospital Los Angeles. He is also an Assistant Professor of Neurology at the Keck School of Medicine at the University of Southern California. Dr. Santoro completed his undergraduate, masters, and medical degrees at Tulane University. He subsequently completed residencies in pediatrics and child neurology at Stanford University School of Medicine and subsequently had sub-specialty training in neuroimmunology and pediatric multiple sclerosis at Harvard Medical School. Dr. Santoro is and passionate NIH-funded physician-scientist who has published over 50 peer-reviewed manuscripts. His clinical and research focus is endocrine dysregulation in pediatric onset multiple sclerosis and the neuroimmunology of Down syndrome. He currently serves on the American Academy of Neurology’s Health Policy Sub-committee and as the representative of the AAN to the American Medical Association. Dr. Santoro is a long-standing advocate for persons with disabilities and has lobbied locally in California and on Capitol Hill.
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