Your child was fine. Then, seemingly overnight, they weren't. The OCD, the rages, the regression, it didn't build gradually. It arrived. That sudden onset is the most important diagnostic clue most doctors aren't looking for.
Key Takeaway
PANS and PANDAS are not psychiatric disorders, they're autoimmune encephalitis responses triggered by infection or toxicity. When strep, Lyme, Bartonella, mold, or other triggers cause the immune system to attack the brain's basal ganglia, the behavioral and neurological symptoms that follow are a direct result of inflammation, not behavioral problems or bad parenting.
Is Your Child Being Affected by PANS or PANDAS?
PANS (Pediatric Autoimmune Neuropsychiatric Disorder) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep) are two conditions that affect thousands of children every year. Typically, these conditions seem to construct themselves overnight, several days, or within weeks. Consequently, a seemingly healthy child may experience a rapid decline in behavior, social skills, and developmental skills if affected by one of these conditions.
These conditions are believed to be the result of an immune response to one of a number of bacterial or viral infections that create autoimmune antibodies that affect the brain.
What are the Similarities and Differences between PANS and PANDAS?
PANDAS is a condition triggered by specific bacteria known as Group A Streptococcal bacteria (most commonly seen as strep throat), which disrupts a child's normal neurologic activity.
PANS is a neuropsychiatric condition that is related to an abundance of other infections and toxicities such as:
- Mycoplasma Pneumoniae / Upper Respiratory Infections
- Mononucleosis (Mono) / Epstein Barr Virus (EBV)
- Mold Toxicities
- Lyme / Lyme Co-Infections (specifically Bartonella)
- Chicken Pox (Varicella)
- Herpes Simplex
- Influenza A / Common Cold
Many of these infections/toxicities may be present in a healthy asymptomatic person; however, they may be the "straw that broke the camel's back" for compromised immune systems.
What are Symptoms of PANS/PANDAS?
Both PANS and PANDAS attack structures of the brain, specifically the basal ganglia. Due to the inflammation rooted at the basal ganglia, neurologic symptoms include:
- Sudden On-Set Obsessive Compulsive Disorder (OCD)
- Separation Anxiety
- Restrictive Eating / Eating Disorders
- Sensory Amplification or Motor Abnormalities (including Tics and Dysgraphia)
- Behavioral Regression
- Sudden Deterioration in School Performance
- Mood Disorders (Irritability, Aggression, and/or Severe Oppositional Behaviors)
- Increased Urinary Frequency / Bed Wetting
- Sleep Disturbances
- Sensitivity to Light
- Severe Mood Swings
The Criteria for Diagnosis:
The criteria for diagnosis for PANDAS includes a checked-box for some of the symptoms above, especially sudden on-set OCD and tics. Clinically, PANDAS is age restricted as this condition is seen in children between 3 years old to puberty. PANDAS also requires a history of a known Group Streptococcal A infection.
The criteria for diagnosis for PANS includes a checked-box for most of the symptoms above. PANS has no age requirement; however, PANS symptoms typically occur in elementary/middle school children (ages 3-14).
How Do We Treat PANS/PANDAS?
At our clinic, functional medicine practitioners use a comprehensive approach to address PANS/PANDAS. This includes working through the "order of operations" (drainage, then parasites, then mold/metals, then infections, then rebuild). Removing the triggering infection/toxicity is key to health.