The Twitching Girls of Le Roy
In October 2011, a seventeen-year-old cheerleader named Katie Krautwurst lay down for an afternoon nap in Le Roy, a small farming town in western New York. When she woke, her chin was jutting forward on its own, her face pulling into expressions she did not choose, her arms flinging out in sharp involuntary jerks. She was a straight-A student with no medical history of anything like it.
Within days her best friend and fellow cheerleader, Thera Sanchez, woke from a nap of her own stuttering, her head snapping sideways, her arms flailing. Then it happened to another girl at the school. Then another.
By December the count at Le Roy Junior-Senior High School had reached a dozen. Over the course of that school year, from October 2011 to June 2012, roughly twenty people were affected: eighteen teenage girls, one teenage boy, and one thirty-seven-year-old woman. Most were students. Many knew each other. Several were cheerleaders or athletes.
The symptoms were consistent across the group and severe. Verbal outbursts. Facial tics. Jerking limbs. Stuttering speech. Episodes that looked like seizures. Arms that flew up without warning in the middle of a sentence. Parents filmed their daughters, and the footage circulated. These were not vague complaints, and they persisted for months in adolescents who had been healthy.
No cause was ever found. The New York State Department of Health tested the school building, the grounds and the water supply. Investigators looked for mold, for fungus, for carbon monoxide, for industrial chemicals, for any shared exposure that might explain a cluster. They found nothing. There was no toxic leak in the walls, no contaminated well, no infection passing between the students, no drug in their systems. Officials also checked a rumor that spread quickly online, that all the girls had received the Gardasil HPV vaccine, and found no correlation. They examined shared activities and identified no single common thread that fit all the cases.
The medical answer came from Laszlo Mechtler, a neurologist at the Dent Neurologic Institute in Buffalo, who treated most of the affected students. With permission from the families, he made his conclusion public: the individual diagnosis was conversion disorder, and taken together the cluster was a case of mass psychogenic illness. In older language, mass hysteria.
Conversion disorder is a recognized condition in which genuine physical symptoms, including tics, paralysis and seizure-like episodes, are produced by the nervous system under psychological stress, without the patient consciously faking anything. The suffering is real; the mechanism, on this account, is neither a poison nor a germ. In an outbreak the symptoms spread socially, from one stressed nervous system to another, particularly among people who see each other every day. Mechtler diagnosed eight students with conversion disorder, identified a few with pre-existing tic-related conditions, and specifically ruled out Tourette syndrome and an infectious agent as the driver of the cluster.
The families rejected the diagnosis. They organized their own advocacy group and pressed for further environmental investigation. Their objection was straightforward: they had filmed their children convulsing, and a psychological label offered no treatment and no accountability.
At that point the case left the local news. In January 2012 two of the girls appeared on NBC's Today Show, visibly ticking on camera, describing their frustration at being handed a psychological explanation and sent home. Other national programs followed. The environmental campaigner Erin Brockovich then sent investigators to Le Roy, focusing on a piece of local history: in December 1970 a Lehigh Valley Railroad train had derailed roughly three to four miles from the school, spilling a large quantity of trichloroethylene, an industrial solvent known as TCE, along with cyanide, into the ground. TCE is a documented neurotoxin.
Brockovich's team was denied access to the derailment site by the state, which fed local suspicion of a cover-up. Soil and water testing did go forward. The results did not show contamination at levels capable of producing the symptoms. Investigators also noted that the distribution of illness did not match a poisoning: the cases clustered among teenage girls in one social group at one school, while brothers, teachers, younger children in the same building and residents who had lived beside the rail line for forty years were unaffected.
A third medical opinion came from Rosario Trifiletti, a pediatric neurologist from New Jersey, who examined a number of the girls and argued that they were suffering from PANDAS, part of the broader category now often called PANS. In that condition a common infection, classically Group A strep, triggers the immune system to produce antibodies that mistakenly attack the brain, causing sudden-onset tics and obsessive-compulsive behavior. Trifiletti reported finding evidence of infection in the girls he tested and placed some on antibiotics. Some families reported improvement.
None of the patterns involved were new to medicine. Mass psychogenic illness is among the oldest documented phenomena in the field, running from the dancing manias of medieval Europe to fainting episodes in convents, to the June Bug epidemic of 1962, when workers at an American textile mill fell ill in waves convinced that an insect in a shipment of cloth was biting them. No insect was ever found. The recurring conditions are consistent: enclosed institutions, high ambient anxiety, a plausible physical explanation close at hand, and a population, very often young women, in constant contact with one another.
Le Roy added one new element. It was described at the time as the first outbreak of its kind to spread through social media. The students were watching each other on Facebook, YouTube and Twitter, seeing the tics and reading the updates, rather than only encountering them in a school hallway.
Recovery tracked with attention. As the media coverage faded, and as doctors urged the girls to stay away from television and from each other's symptom updates online, many of them steadily improved. By the following school year the twitching had largely stopped and the news crews had gone. One girl was ultimately diagnosed with Tourette syndrome. The rest returned to ordinary life. The school building tested clean, the water tested clean, and no agent was ever identified.
Conclusions and Open Questions
Three explanations were put forward, and each has a weakness that keeps the case open.
The official verdict, from Mechtler and consistent with the state health department's findings, is mass psychogenic illness. Its strengths are substantial: the demographic profile matches outbreaks recorded for centuries, overwhelmingly among adolescent girls in tightly bound groups such as schools, convents and factories; exhaustive environmental testing produced nothing; and recovery correlated closely with distance from cameras and from each other's symptom feeds, which is how a stress-driven, socially transmitted disorder behaves and is not how a chemical spill or a streptococcal infection behaves. Its weakness is that it is a diagnosis of exclusion. There is no laboratory test that confirms conversion disorder, so the conclusion rests on the failure to find anything else, and it cannot be verified case by case.
The environmental theory, advanced by Brockovich and by many of the families, pointed to the 1970 TCE and cyanide spill near the school. Its strength is that the spill was real, TCE is genuinely neurotoxic, and the state's refusal to allow access to the site was never adequately explained. Its weakness is the shape of the outbreak. Groundwater contamination does not select teenage girls in one friendship group while sparing their brothers, their teachers and forty years of neighbors, and the testing that was done found no levels able to account for the symptoms.
The autoimmune theory, from Trifiletti, offered a physical mechanism in PANDAS or PANS. Its strength is that the condition is real and that he reported infection markers in the patients he tested. Its weaknesses are the rarity of the condition, which makes a dozen or more simultaneous cases in one school and one social circle difficult to reconcile with what is known about its incidence, and the fact that improvement on antibiotics is not proof of cause, since the symptoms waxed and waned on their own and the treatment carried obvious placebo weight for frightened families.
There is also an open theory about how the case was handled rather than what caused it. Some argue that the psychogenic diagnosis was convenient for every institution involved, because if the symptoms originated in the patients' own nervous systems, then the railroad's old spill becomes irrelevant, the state's refusal to open the derailment site becomes defensible, and no cleanup or apology is owed. Anthropologists who studied Le Roy, among them Robert Goldstein and Kira Hall, made a version of this point in print: the vocabulary of brain science, whatever its accuracy, was deployed in a way that closed the environmental inquiry before it was finished. This is a claim about institutional behavior, not evidence of contamination, and it does not by itself make the diagnosis wrong.
What remains unexplained is narrower than the public argument. No one established which of the roughly twenty cases were organic and which were socially transmitted, and the count of formal conversion-disorder diagnoses, eight, is well short of the total affected. The initial case has never been accounted for beyond the diagnosis itself. And the mechanism by which symptoms travelled through screens rather than hallways was described but never measured.
The open questions follow from that. Can an outbreak be attributed to psychological transmission when there is no positive test for it, only the absence of alternatives? Was the environmental investigation closed prematurely, and would a completed one have changed anything? If social media can carry symptoms between people who never share a room, how would anyone recognize the next outbreak of this kind, or distinguish it from a physical illness with a physical cause?