As a parent, one of the scariest experiences of my life was seeing my child wake up with OCD symptoms virtually overnight. Separating food, acting aggressively, losing the ability to get to sleep, facial tics — these are just a few PANS/PANDAS symptoms.
We have walked through these with our own child and now share the hope we found with our patients encountering the same thing.
PANS and PANDAS are closely related disorders, sharing the same symptoms and same treatment options. Their causes and diagnosis criteria, however, are a little different.
It’s important for parents to understand PANS/PANDAS and be able to spot the symptoms right away.
PANS stands for “Pediatric Acute-Onset Neuropsychiatric Syndrome.”
PANDAS stands for “Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.” PANDAS is technically a subset of PANS, even though PANDAS was identified first.
PANDAS happens when a Group A strep infection¹ (such as scarlet fever, strep throat, or rheumatic fever) seems to trick a child’s immune system into attacking their own brain, specifically the basal ganglia.² This leads to sudden onset OCD and other mental health symptoms.
PANS is basically the same autoimmune disorder, but the sudden onset of symptoms occurs in the absence of a strep infection. There is less known about what can trigger PANS, but here are some suspected PANS triggers:³
PANS/PANDAS affect children between 3 years old and puberty. A person’s susceptibility to PANDAS usually goes away with puberty.
Boys are twice as likely as girls to develop PANDAS.⁶
A clinical diagnosis of PANDAS includes:
PANDAS symptoms have been broken up into eight categories if you count OCD as the first. These eight categories were decided on by a group of experts in 2010, including PANDAS forerunner Dr. Susan Swedo.⁸
The primary PANDAS symptom is abrupt onset OCD.
Other symptoms stem from this obsessive-compulsive behavior, which involves obsessions (recurrent and persistent thoughts) and compulsions (repetitive behaviors or mental acts).
OCD symptoms may manifest as an eating disorder, so that’s considered in the diagnostic criteria.⁹
PANDAS may trigger several forms of anxiety:
In mild cases of PANDAS, a nearby parent can comfort a child’s anxiety, helping the child go to sleep or rest.
“Emotional lability” is when a child switches from one emotion to another in an instant. For example, a child might be laughing and suddenly start crying for no reason.
Emotional lability has been known to lead to sudden depression. In severe cases, suicidal thoughts occur.
Children with PANDAS may exhibit sudden aggression. In milder cases, your child might simply be more irritable than usual. “Oppositional behavior” refers to conflicts that arise when children stubbornly refuse to follow parental directions or the instruction of teachers.
When a child reverts to an earlier stage in their development, this is called “behavioral regression.” A seven-year-old might start using baby talk, lose the ability to draw, or play with toys they haven’t touched in years.
This can be a tricky neuropsychiatric symptom. It’s important to make sure a child’s behavioral regression is not a symptom of ADHD or autism.
One of the more time-sensitive symptoms of PANDAS is a sudden drop in academic performance.
If a child suddenly develops symptoms of OCD, aggression, depression, and behavior regression, it’s no surprise that poor school performance follows.
A child’s immune system attacks the brain, but this affects more than just the child’s mental health. They may develop:
Somatic symptoms usually include changes in a child’s sleep and urinary frequency. They may develop:
PANS/PANDAS symptoms are essentially identical. The main difference between PANS and PANDAS is the cause of the symptoms. Whereas PANDAS is triggered by a strep infection, PANS is broader. PANS may be triggered by a number of infections, such as chickenpox, H1N1 flu, or Lyme disease.¹²
Researchers suggest a multidisciplinary approach¹³ to treatment options for PANDAS . At The Center for Fully Functional® Health, we take this a step further using our Fully Functional® process:
Although other physicians may treat PANS/PANDAS, our Fully Functional® process separates us from the crowd. Our organized approach provides your child and your family the best chance at recovery.
Here are the treatment options that may be used to treat PANDAS:
You need to work with us! We are experts in PANS/PANDAS diagnosis and treatment.
If you think your child may have developed symptoms of PANDAS or PANS you can book an appointment at our functional medicine practice by clicking here. We are also happy to speak with you at (317) 989-8463, Monday-Thursday, from 8AM – 5PM Eastern time.
You can book an appointment by clicking here, or please call us at (317) 989-8463, Monday-Thursday, from 8AM – 5PM Eastern time.
Sources:
1 https://nccid.ca/debrief/group-a-streptococcus/
2 https://www.neuroscientificallychallenged.com/blog/what-are-basal-ganglia
3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340632/
4 https://www.who.int/
5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6423671/
6 https://www.semanticscholar.org/paper/From-Research-Subgroup-to-Clinical-Syndrome%3A-the-to-Swedo-Leckman/fddbf448ed32d6117e390fe788e40562e8710c54?p2df
7 https://www.ncbi.nlm.nih.gov/books/NBK333433/
8 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340805/
9 https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml
10 https://www.ldonline.org/ld-topics/writing-spelling/what-dysgraphia
11 https://www.sleepfoundation.org/night-terrors
12 https://www.cdc.gov/h1n1flu/qa.htm
13 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340335/
14 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353234/
15 https://pubmed.ncbi.nlm.nih.gov/29722936/
16 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5826468/
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