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Monday, November 2, 2009

Article by the Director of General Neurology at Yale regarding the Redskins cheerleader who claims that she got Dystonia from the flu shot

Dystonia Case Follow Up

Published by Steven Novella under Neuroscience

In an interview for the SGU Christopher Hitchens told me that typically, after publishing a story, only then do people contact him that he should have spoken to in the first place. My humble blog has nothing of the reach of Hitchens’ writing, but it is still occasionally the case that after posting a blog I am contacted by people I really wish I had spoken to before I finished writing it.
For example, on Friday I discussed the case of Desiree Jennings, the 25 year old woman who claims to have developed dystonia 10 days after receiving the seasonal flu vaccine. I reported that all of the neurological experts who viewed the videos of Jennings that were made public (including me) are of the opinion that she does not have dystonia. Rather, the signs she displays are more typical of a psychogenic movement disorder, and therefore not due to the vaccine.

There is another angle to this story, however, that I was not aware of. I was mostly interested in the vaccine angle, as the Jennings story has been exploited by the anti-vaccine movement to further scare-monger about the flu vaccine. There is also a dystonia community, and they were not happy about the Jennings affair either. In particular, a woman by the name ofRogers Hartmann, who suffers from dystonia, and who has been one of the main faces of dystonia activism to the media, contacted me.

The dystonia community is concerned that the fact that neurology experts are forced to go on public record that Desiree Jennings’ symptoms are more consistent with a psychogenic disorder rather than a true neurological disorder may generate confusion in the public about the nature of dystonia itself. Fair enough – although I thought the doctors who were interviewed on Fox were pretty clear. I will also add here that dystonia is a perfectly legitimate movement disorder. It is, in fact, a brain disorder that results in involuntary muscle contractions. It can be very debilitating. The Desiree Jennings case should not confuse anyone about the nature of true dystonia.

But there is more still. Generation Rescue, the anti-vaccine group started by J.B. Handley and now fronted by Jenny McCarthy, was quick to jump on this case as a legitimate vaccine injury. But they then quickly distanced themselves from the case, removing the web page they had set up for Jennings. Here’s why.

The story appears to have been broken by the Loundountimes.com. Reporter Nicholas Graham discloses the Jennings is a colleague of his, and undoubtedly that is how he heard of her story. The story was then picked up by a Fox affiliate in DC, reported by Claudia Coffey. From there it was picked up nationally by Fox News and Inside Edition.

Generation Rescue president, Stan Kurtz, apparently saw the Jennings story as an opportunity to get some free press for their anti-vaccine nonsense. They “reached out” to Jennings. Here is what Kurtz had to say in an interview with Coffey.

“And the story is, anyone that sees– it is just so compelling, Jenny was crying over it,” says Kurtz.

Kurtz also believes with the proper treatment, some of her symptoms may be reversible.

“Well, unfortunately we happen to be very good at handling vaccine injury. We’ve got a lot of doctors that have experience in doing that, so our doctors and our resources are completely available to her, and we’re going do everything we can to give her a lot of options to, to help take care to help recover from this condition as best we can,” says Kurtz.

Poor Jenny was in tears, and Kurtz was ready to help by unleashing anti-vax quackery to treat Jennings.

But then Kurtz and Generation Rescue ran into a real patient advocacy group – Rogers Hartmann and dystonia activism. Hartmann runs an independent dystonia charity, lifewithdystonia.com. It was clear to Hartmann (as it was to anyone sufficiently familiar with dystonia) that Jennings did not have dystonia. She called Fox and Stan Kurtz – and then the furious backpedaling began. Until then Coffey had accepted the story at face value, without any journalistic due diligence in evidence. When she learned that perhaps she had been snookered, the panicked calls to Hartmann began.

It was not until after Hartmann became involved, and the e-mails and phone calls of many other dystonia activists putting pressure on Fox, did they do follow up reporting, such as interviewing Dr. Stephen Grill about dystoniaand the fact that Jennings does not have it.

It was also due to Hartmann that Generation Rescue was (partially) saved from its own stupidity and zealotry. Stan Kurtz was going full-steam ahead, as if Generation Rescue had the expertise to diagnose and treat vaccine-induced dystonia (an entity never reported in the medical literature). And then (after being contacted by Hartmann and having the truth of the matter explained to them) suddenly and without a word, Generation Rescue backed away from Jennings and took down the web page.

I wonder if they will be as interested in helping Jennings now that they cannot exploit her case to fear monger about vaccines.

Curiously, the Age of Autism blog (never ones to let the facts get in the way) is still treating the case as a legitimate story of vaccine injury. Although they are being a bit cagey. They are just printing a letter from Jennings, with a preamble dismissing expert opinion that her disorder is psychogenic. They do this by explaining the etymology of the word “hysteria”, which is not exactly a synonym for psychogenic (in fact “hysteria” is no longer used because of its connotation). I guess they deny all psychogenic illness, even though it is very well described in the neurological literature.

I have personally seen cases that were proven to be psychogenic. These are not just cases where we cannot find a neurological cause – it is not a guess or a last resort. There are cases in which the neurological signs and symptoms on display are anatomically impossible – where a psychogenic cause is the only plausible explanation. And it is treated as a real and serious disorder – just a psychological disorder, rather than a neurological one. Ironically, AoA is trying to imply that neurologists who invoke the psychogenic diagnosis are being insensitive, but in reality they are basing their implications on a premise that is itself insensitive – a rather unsophisticated and harmful denial of psychological illness.

So far, AoA is still running with the story, writing in follow up about how Jenny McCarthy and Jim Carey were so kind to reach out to Jennings. I guess they didn’t get the memo from their sponsor, Generation Rescue, to back off.

This is an unfortunate story, and I wish Desiree Jennings the best. I hope she finds her way to a competent clinician and does not get caught in the maelstrom of quackery that is sure to follow her.

But this is not a story of a woman injured by a vaccine. This is not even a rare vaccine reaction. It is something else. Neurological experts know it, and the dystonia community knows it.

This is also a story of irresponsible journalism. As Hartmann pointed out to me – most national media outlets did not touch this story, because even basic journalism would have uncovered that there is something fishy here, and no good journalist wants to get caught with their pants down. This is also a story of how irresponsible the anti-vaccine movement is. They were quick to exploit this case for its emotional appeal, pretending to have expertise they lack, and got it completely wrong. That’s a good summary of the anti-vaccine movement as a whole.

8 comments:

  1. FINALLY! Someone sums up what has been going on. Thank you, Dr. Novella. This is interesting and so helpful based on all that I have read about this case where the facts about this woman's condition keep changing. The last i heard she did not know that Jim Carrey and Jenny McCarthy publicly disconnected from her AND she told people that a physical therapist at Johns Hopkins had diagnosed her AND she told people that was going to try to get her flu shot extracted from her body. It has gotten sad/funny at this point. And I heard from a lawyer that I know that some Federal Laws have been broken.

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  2. If you have a query for Dr. Novella, please post on his website. One person has already gotten it backwards. The anti-vaccine is or WAS trying use "Dystonia" to further their scare tactics. That is CLEAR. For the record, I never get the flu shot. And won't get either one this year. Just because I don't feel like it and I haven't gotten a flu shot in 20 years and seem to be doin' just fine. I do wish people would read more clearly that our tribe was being used ERRONEOUSLY to further another cause that Dystoniacs may or may not support. It is VERY wrong.

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  3. This is not a rhetorical question and as the self-appointed spokesperson for the "dystonia community" I have to ask you the following...but first, a quote from Dr. Novella's post: "It was clear to Hartmann...that Jennings did not have dystonia."

    On what do you base your clinical assessment of Ms. Jennings? Other than having dystonia yourself, what qualifies you to make a diagnosis of psychogenic disorder? It's in the post...in glorious gray and white. Dr. Novella directly states that you don't think it's dystonia. What information did you access to arrive at your conclusions?

    This is a serious request for information. You posted it, so I expect you have the "journalistic integrity" to back up your claim.

    Anxiously awaiting your reply...

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  4. Hi Anonymous who won't post their name. :)

    I spoke with 8 of the top Dystonia specialists in the world and had them review her emails, video and her comments to media.

    They all, without hesitation, said that it is absolutely NOT Dystonia.

    Maybe you have not seen all of her comments about REVERSING Dystonia and using machinery to get better and getting plasma replacement AND trying to EXTRACT the flu vaccine from her body.

    Wow.

    That is why I everyone has detached themselves from her.

    She is talking about treatments and details that have nothing to do with Dystonia.

    Does that answer your question. Also, as we all are, I am allowed to have my opinion after speaking with the top folks who treat us and get us better.

    RH

    I would never say that without talking to the top guys. I am an advocate and the doctors were happy that I was speaking up about the truth.

    There is already too much misinformation about Dystonia and it hurts all of this. Thanks for asking this question.

    Rogers Hartmann

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  5. Also, Anonymous -- where did I self-appoint myself as the Dystonia spokesperson?

    I just took action and answered phone calls and emails.

    I asked the heavies in Dystonia. So, that snide comment will turn most people off since that is not based on anything that Dr. Novella wrote.

    There is always one of you. I am trying to help our tribe and you are focusing on something that is NOT even in Novella's piece.

    I work, I help out where I can and I deal with Dystonia EVERY day of my life -- and people like you are hellbent on being disrespectful. It says a lot about who you are and has NOTHING to do with me and people know that.

    Thanks for your writing -- if you were really brave, you would say who you are and why you are questioning me when I am trying to do right by people who are suffering and being used by another foundation for their own anti-vaccine message.

    Good luck to ya. Back to work! Have a great rest of the day.

    RH

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  6. By the way, I do apologize for the "self-appointed" remark. It was the good doctor and not you who referred to the "dystonia community"...as if we were some monolithic group who unquestionably agreed with his opinion of psycho-genesis and are now somehow unsettled by it. It should be apparent by now that we are all very different people with different opinions...just like everybody else.

    I, too, have struggled every day of my life with this awful disorder for the last 10 years. Sometimes I write before I think. If you took any of my words as a personal attack, then I sincerely apologize

    I stand by the rest of my comments.

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  7. Graham FindlayNov 8, 2009 04:01 PM

    Have to say that i was diagnosed as a "psychogenic" case in London back in the 1970's - when I developed spasmodic torticollis in my early teens. It totally screwed up me and my mother for years - the Freudian psychiatrist identified her as the root cause of my hysteria/traumautic reaction, when "refrigerator mother" theory was all the vogue.
    The neurologist Professor Marsden, who is now recognised as a world pioneer on dystonia, eventually diagnosed my condition as organic and physiological,not psychopathological.
    We need to be vigilant against any inaccuracies that frame dystonia as psychogenic or hysterical.
    Regards,
    Graham

    ReplyDelete

The Little Hartmanns -- the loves of my life.