How Long Does it Take to Treat PANS/ PANDAS?

Is Your Child Struggling with PANS/PANDAS?



  • The number of PANS/PANDAS cases is rising.

  • PANS can be triggered by infections or non-infections. 

  • PANS symptoms can come on rapidly, or can happen slowly over time (unlike popular belief in conventional medicine)

  • Functional medicine providers get to the root cause of PANS, instead of just focusing on antibiotics usage.

  • The functional medicine approach focuses on testing, diet, supplementation and other holistic methodologies. 




More and more kids are being diagnosed with a chronic condition. Actually, a whopping 1 in 2 kids have some sort of chronic condition ranging from eczema to asthma to autoimmune disorders and even neuropsychiatric issues. Included in these are the rising cases of PANS/PANDAS.



What is PANS/PANDAS?

PANS stands for pediatric acute onset neuropsychiatric syndrome. PANS/PANDAS are forms of infection-triggered autoimmune encephalitis (inflammation of the brain), which causes a disruption of a patient's normal neurologic functioning. 



When PANS is triggered by strep, the diagnosis is then considered as PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections). 



While many other infections may trigger PANS (such as Lyme's disease, herpes 1 and 2, roseola virus, Epstein-Barr virus, along with others), PANS doesn't always have to be triggered by an infection. It can also be triggered by non-infections like environmental toxins, heavy metals, and mycotoxins.

 
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Symptoms of PANS/PANDAS

The following symptoms usually come on very rapidly or seemingly overnight. Keep in mind, however, that these can also become apparent slowly over time. 




There's no social reasoning behind these behavioral changes- like entering a new class at school, a new sibling, or a rough situation at home (divorce or moving towns, etc.). Also, these signs aren't just a "phase". They don't go away with time and may actually get worse.




  • Anxiety

  • Rage/Irritability

  • OCD

  • Sensory Sensitivities

  • Sleep Disturbances

  • Inability to Concentrate

  • Food Restriction 

  • Cognitive Decline

  • Urinary Problems Like Frequent Urination 

  • Handwriting Decline

  • Dilated Pupils (due to constant fight or flight response)




Unfortunately, many conventional PANS treatment programs require that these symptoms rapidly develop from their cognitive and behavioral baseline. Yet, we see more and more that this doesn't necessarily have to be the case. For many kids, symptoms can still come on slowly. The requirement of rapid onset for a diagnosis sadly causes misdiagnosis for many children. 




In fact, up to 4 million kids get diagnosed with serious anxiety/phobia/OCD/bipolar in a given year. PANS experts believe that at least 25% of these kids get misdiagnosed each year. 

 
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Risk Factors for PANS/PANDAS

A study conducted in Sweden found that 48% of patients had a family history of developmental or neuropsychiatric disorders in a first-degree relative (parents or sibling), and 48% had a family history of inflammatory or autoimmune diseases in a first-degree relative.




The study also showed that 74% of the children had either been previously diagnosed with a developmental disorder or had symptoms indicative of developmental problems.




PANS/PANDAS Biological Findings

Studies suggest that cytokine dysregulation plays a role in tic disorders related to PANS. Patients struggling with PANS may have higher cytokine levels, specifically serum TNF-α levels, which are involved in systemic inflammation. Remember that PANS is when there is inflammation of the brain. 




Studies have shown a correlation between antineuronal antibodies (which are present in the serum of patients with neurological problems) and tic and obsessive-compulsive disorders (OCD) associated with group A streptococcal infections (as seen in PANDAS patients).




Conventional Treatments of PANS/PANDAS

Unfortunately, since PANS was only recently discovered and recognized, many children with PANS/PANDAS are often misdiagnosed and are treated with psychotropic drugs to manage their symptoms. The conventional medicine approach fails to resolve the root underlying cause of their illness.




If they do figure out that it's PANS/PANDAS, most doctors just focus on the Strep trigger, treating kids with antibiotics to combat the strep infection. However, when this happens, doctors could be missing a whole range of kids who are struggling.




Functional Treatment of PANS/PANDAS

Knowing what kind of infection you are facing and understanding the child's immune system function is extremely important. We know it is more than just a Strep related issue.




It is important to note that PANS/PANDAS is a clinical diagnosis. However, there are clues to help assess and determine this diagnosis. Functional medicine providers use lab testing to find the source of the infection (i.e., Strep, EBV, Lyme, and others) to utilize targeted therapy.




These can include:

  1. Testing their reaction to anti-inflammatory medication

  2. Using the anti-DNase B strep antibody marker

  3. Ordering a Cunningham panel to look at autoimmune antibodies




Here are some steps that a functional medicine provider might use to address PANS/PANDAS cases.

  • Take an in-depth medical history to find the underlying cause of what exactly needs to be treated (what kind of infection is it...if it is an infection).

  • Before using long term NSAIDS or antibiotics, the inflammation will be addressed with natural methods first. This can be done with the supplementation of omega-3 fatty acids, curcumin (a component of turmeric), eating clean organic whole foods, and cutting out processed foods and foods with high added sugars. 

  • Guidance through the proper steps to identify and treat underlying imbalances such as food sensitivities, gut dysfunction, nutritional insufficiencies, leaky gut, detoxification issues, methylation and mitochondrial problems.

  • Use homeopathy tools, acupuncture, essential oils, acupressure, and cranial osteopathy.




Some tests could include:




Basic Blood Work Testing:

  • IgE 

  • IgM

  • IgA

  • IgG (subclass 1, 2, 3, 4)

  • CBC

  • B-12

  • ANA

  • Ferritin

  • Vitamin D




Viral or Bacteria Testing:

  • Strep throat culture, 48-hour culture, or perianal culture

  • Antistreptolysin O (ASO), group A strep

  • Streptozyme

  • Anti dNase B

  • HHV-6 Titers

  • Mycoplasma Pneumoniae IgA & IgM

  • Epstein Barr Virus Panel

  • Pneumococcal Antibody Titers

  • Coxsackie A & B Titers

  • Lyme Disease and co-infections




Cunningham Panel* - autoimmune autoantibody levels: 

  • Dopamine D1 receptor

  • Dopamine D2L receptor

  • Tubulin

  • Lysoganglioside GM1

  • CaM Kinase II




Additional Testing May Include:

  • Food Sensitivity Testing

  • Microbiome Testing

  • GI Stool Testing

  • Micronutrient Testing




How Long Does it Take to Treat PANS/ PANDAS?

There is a wide time range for how kids respond to treatment. Some may see a difference after a couple of weeks, but for other kids, it may take a couple of months or even years to get back to 100% functioning, like where they were before. 




We get to the root cause of PANS/PANDAS with functional medicine to stop the episode from occurring.




Contact Kansas City's Functional Medicine Doctor

If you are worried that your child may be struggling with PANS/PANDAS, please contact Dr. Jaban Moore. Dr. Jaban Moore is a functional medicine provider in Kansas City that can help. He specializes in addressing challenges related to chronic illnesses and diseases. He creates personalized protocols specific to your child's body and genetic make-up. Please reach out if you want to overcome these struggles with your child. You can give the office a call at (816) 889-9801.




Jaban Moore