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This study presents a pediatric MPI outbreak involving abrupt-onset tics in LeRoy, NY, during 2011-2012. The analysis provides diagnostic evidence and highlights challenges with diagnosing MPI. Patients presented with tics evolving into syncope, psychogenic nonepileptic seizure, and migraine. Laboratory test types (n\u2009=\u200964) were evaluated, with n\u2009=\u200932 of 64 yielding abnormal results. Deviations were reported in 5% intervals for quantitative tests, with n\u2009=\u200913 of 32 test types &lt;10% and n\u2009=\u200914 of 32 test types &gt;10% from normal. The remaining n\u2009=\u20095 of 32 test types were qualitative. Brain magnetic resonance imaging (MRI) results found n\u2009=\u20097 of 13 normal, n\u2009=\u20094 of 13 normal variants, and n\u2009=\u20092 of 13 abnormal. Electroencephalography (EEG), electrocardiography, head computed tomography (CT), and echocardiogram results were normal. All patients recovered from MPI. Clinical presentation supported the MPI diagnosis; laboratory\/ancillary testing did not support an alternative. Abnormal results were either consistent with patient history, incidental, or treated without symptom resolution. Outside environmental testing did not yield an alternative.<\/jats:p>","DOI":"10.1177\/08830738251369759","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T14:55:17Z","timestamp":1757343317000},"page":"529-538","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["An Occurrence of Mass Psychogenic Illness: LeRoy, New York"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0018-1644","authenticated-orcid":false,"given":"Jennifer","family":"McVige","sequence":"first","affiliation":[{"name":"Department of Pediatric and Adult Neurology, Headache Medicine, and Concussion Center, Dent Neurologic Institute, Buffalo, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lanie","family":"Masset","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adult Neurology, Headache Medicine, and Concussion Center, Dent Neurologic Institute, Buffalo, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laszlo","family":"Mechtler","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adult Neurology, Headache Medicine, and Concussion Center, Dent Neurologic Institute, Buffalo, NY, USA"},{"name":"Dent Neurologic Institute","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Rooney","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Eugeni","sequence":"additional","affiliation":[{"name":"School of Medicine, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilpreet","family":"Kaur-Spencer","sequence":"additional","affiliation":[{"name":"Madigan Army Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Trzcinski","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adult Neurology, Headache Medicine, and Concussion Center, Dent Neurologic Institute, Buffalo, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhongzheng","family":"Niu","sequence":"additional","affiliation":[{"name":"State University of New York at Buffalo"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2174\/1745017901208010110"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425787"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/ede.0b013e3181e9edc4"},{"key":"e_1_3_3_5_2","volume-title":"Kaplan and Sadock\u2019s Synopsis of Psychiatry: Behavioral Sciences\/Clinical Psychiatry","author":"Sadock BJ","year":"2011","unstructured":"Sadock BJ, Sadock VA. 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