Two Adolescent Brothers with Postviral Encephalitis Neurological Syndrome and Associated Psychological Overlay involving Parental Enmeshment

Abstract

The complexities of this case centers on two brothers, Philip and Mark, and their analogous symptoms. Both brothers appeared to have parallel cognitive and emotional disorders without clear etiologies ever established. Viral and other infectious illnesses were put forward as putative causes but without any clear evidence that these were actually the etiologic agents. Both boys were initially seen for assessment of a probable post-infectious encephalopathy or an autoimmune reaction associated with a streptococcal pharyngitis. While there there was no family history of cognitive or psychiatric illness, some genetic underpinning must be entertained until proven otherwise. Philip, age 15, presented first. His brother Mark, age 13, was initially seen 7 months later. Complicating this picture is the suspicion of interpersonal complicity among the boys and their parents, encouraging the mirroring of symptoms.