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Penicillin for acute sore throat in children: randomised, double blind trial

BMJ 2003; 327 doi: (Published 04 December 2003) Cite this as: BMJ 2003;327:1324

Encephalitis lethargica syndrome in London, 2004.

Dear Sir,

January 2004 the Great Ormond Street Hospital and Institute of Child
Health published a paper on pharyngitis, complicated by sleep disorder,
lethargy, parkinsonism, dyskinesia and neuropsychiatric symptoms.

Autoantibodies reactive against discrete basal ganglia autoantigens
are present.

It is therefore possible that Streptococcus may play an aetiological
role in the Encephalitis lethargica phenotype, as it does in Sydenham's

Dale RC, Church AJ, Surtees RA et al.: Encephalitis lethargica
syndrome: 20 new cases and evidence of basal ganglia autoimmunity. Brain

Competing interests:
None declared

Competing interests: No competing interests

19 June 2006
Friedrich Flachsbart
General Medicine Praxis
37085 Göttingen-Geismar