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PANDAS

PANDAS is PANS specifically triggered by strep, and the strep connection changes the investigation entirely.

PANDAS is a subset of PANS specifically linked to Group A Streptococcal (strep) infection. In PANDAS, antibodies the body produces to fight strep cross-react with brain tissue, triggering the neuropsychiatric symptoms characteristic of the condition. Key presentations include sudden-onset OCD, motor or vocal tics, severe separation anxiety, and behavioral regression following a strep infection, sometimes even a subclinical one the child never appeared sick from.

Testing tools include throat cultures, ASO titers, Anti-DNase B antibody panels, and the Cunningham Panel, a specialized blood test designed to detect antibodies associated with neuroinflammation. Dr. Jaban works with PANDAS families to identify the strep trigger, address any co-existing infections or environmental factors, and support the child's neurological recovery comprehensively.

Common Symptoms

  • Sudden-onset OCD
  • Motor or vocal tics
  • Severe separation anxiety
  • Behavioral regression
  • Urinary frequency or urgency
  • Emotional lability
  • Sensory sensitivities
  • Sleep disturbances
  • Cognitive deterioration
  • Food restrictions

Understanding This Condition

PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is a subset of PANS specifically linked to Group A Streptococcal (strep) infection. In PANDAS, antibodies the body produces to fight strep cross-react with brain tissue, triggering the neuropsychiatric symptoms characteristic of the condition. Key presentations include sudden-onset OCD, motor or vocal tics, severe separation anxiety, and behavioral regression following a strep infection, sometimes even a subclinical one the child never appeared visibly sick from.

Why It Gets Missed

Testing for streptococcal involvement involves culture tests and antibody assessments. Antistreptolysin antibodies are generated in reaction to the toxin enzyme streptolysin O, released by Group A Streptococcal bacteria, and the ASO test can indicate their presence. The Anti-DNase B strep antibody blood test examines the body's response to Group A Streptococcal microbial infections. If test results are negative yet PANS symptoms persist, streptococcal involvement can be eliminated and alternative causes such as Epstein-Barr Virus, Mycoplasma, and others explored.

Dr. Jaban's Approach

The Cunningham Panel is a blood test designed to detect specific antibodies associated with neuroinflammation, contributing to the symptoms seen in PANS/PANDAS. This diagnostic tool aids in distinguishing whether conditions such as OCD, seizures, behavioral regression, and tics are a result of an autoimmune response to infections affecting brain function rather than originating from a neuropsychiatric disorder.

The Neural Zoomer Plus Test by Vibrant Wellness evaluates reactivity to 48 neurological antigens linked to various neurological diseases. At The Redefining Wellness Center, working with a practitioner is highly urged when dealing with PANS/PANDAS or any pediatric neurological condition.

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