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Susser Syndrome Update

Susser Syndrome description (for EDOH site)

Since March of 2003, a number of Epiville residents have been complaining of various non-specific neurological symptoms including:

• Dizziness
• Double-vision
• Fainting spells
• Difficulty concentrating.

Researchers investigating these cases of illness have identified more specific neurological symptoms that are indicative of the rare neurological disorder Susser Syndrome. These specific neurological symptoms include

• Anosmia (loss of the sense of smell)
• Development of facial tics
• Impaired proprioception (see below)

Diagnosis:

Currently, diagnosis of Susser Syndrome is based on a combination of these neurological symptoms as identified during clinical investigation by a neurologist (the so-called Clinician Gold Standard for diagnosis Susser Syndrome). Susser Syndrome can also be diagnosed based on the appearance of changes in brain tissue identified on a functional magnetic resonance imaging (fMRI) scan. fMRIs are extremely expensive to administer and therefore cannot be routinely performed on all individuals complaining of symptoms consistent with Susser Syndrome.

In some very advanced cases the changes in brain tissue visible on fMRI are irreversible and lead to severely impaired proprioception . Proprioception refers to the unconscious perception of movement and spatial orientation. Individuals without it lack the ability to direct the body's various parts to move and must resort to using visual clues. Impaired proprioception is routinely tested by police officers via a "field sobriety test," which asks individuals suspected of being under the influence of alcohol or other drugs to perform a set of tasks (such as touching their nose with their finger) with their eyes closed. In more severe cases, individuals lacking proprioception are unable to stand or walk or move their limbs without conscious effort.

Susser Syndrome is a degenerative disease, with individuals gradually exhibiting more severe symptoms as their condition progresses. Researchers have broken down the Syndrome into 3 stages for classification purposes:

• Stage I: Patients have a positive result on the fMRI scan and minor non-specific symptoms of dizziness, double-vision, fainting spells, as well as difficulty concentrating
• Stage II: Patients exhibit more pronounced symptoms mentioned in Stage I and additionally experience anosmia and facial tics
• Stage III : Patients meet all of the criteria of Stage II and additionally exhibit severely impaired proprioception

Susser Syndrome is not fatal; however, the resultant disability is so severe that every individual who is afflicted is brought to the local academic hospital for treatment - no case goes undetected. Prior to March, only a handful of Susser Syndrome cases had ever been diagnosed at the Epiville General Hospital. The induction time of Susser Syndrome is believed to be at least 6 months, from the moment of first exposure until the first appearance of symptoms.