The word “PANDAS” normally makes you think of those cute, furry animals chomping on bamboo sticks, but in the last decade, it has become the answer to so many overwhelmed and concerned parents. Parents whose children suffer from a complex, misunderstood, underdiagnosed disorder called Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infection now have an answer. As you review the below information on PANS / PANDAS, consider calling a holistic pediatrician for any additional questions.
How Does PANDAS Affect My Child?
PANDAS can occur days or even four to six months after a simple strep throat infection if it is not fully cleared, or a child’s immune system mistakenly starts attacking healthy brain tissue. As the body’s immune system is working to respond to the infection, it creates secondary inflammation in part of the brain and other parts of the body. This neuroinflammation may lead to abrupt onset of behavioral, emotional, and physical changes in a child.
It affects 1 in 200 kids, but PANDAS is often misdiagnosed because it is a new disorder and many pediatricians and parents do not know it exists. The first study for PANDAS was published in 2002, where 12 children had abrupt onset of OCD behavior following a group A streptococcal pharyngitis infection. Researchers consider it an auto-immune condition and have even added PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) as a differential after linking the same type of neuroinflammation with other infection exposures such as Lyme disease, mycoplasma pneumonia, environmental stressors, herpes simplex, and numerous other common viruses.
With such a broad range of infections that have been linked to PANS, this may help so many children diagnosed with mental illness. Some experts suspect 25% of the children diagnosed with severe anxiety, OCD, Tourette’s, bipolar disorder may be linked to PANS/PANDAS.
What Are the Signs and Symptoms of PANS/PANDAS?
The most common symptoms that have been reported include the following:
- Becoming a picky eater
- Hyperactivity/difficulty concentrating /change in math and writing skills
- OCD behavior
- Personality/Mood changes such as anxiety, depression or aggressive behavior
- Sensory sensitivities such as a need to touch or smell certain objects, a heightened sensitivity to noises, hallucinations
- Somatic symptoms such as bedwetting, urinary frequency, or sleep disturbances
- Vocal or Motor Tics/irregular involuntary movements of the arms, legs, trunk or facial muscles
How Would a Holistic Pediatrician Diagnose PANS/PANDAS?
Diagnosing a child with PANS/PANDAS is difficult, because there is no definitive test currently available. The following are assessed:
- Auto-immune/Immunodeficiency markers
- Blood antibody testing specific to a type of infection
- Cunningham panel
- Environmental allergies
- Family history
- Food allergies/sensitivities
- Physical and mental health assessment
- Timeline of events with an infection and signs or symptoms
What is the Treatment for PANS/PANDAS?
The current guidelines recommend treating based on severity of symptoms. For mild cases, a trial of antimicrobials or anti-inflammatories/steroids are often used. When treating PANDAS, antibiotics may be used until strep antibodies are back to normal. With PANS, treatment would depend on any current other infections, allergens, or toxicities.
Initiating IVIG/immunology may be necessary to support the immune system for moderate cases. For severe cases, plasmapheresis or has shown benefit. Psychiatric medications may be beneficial if the OCD, tics, or anxiety are affecting daily life. Referrals to neurologists, endocrinologists, rheumatologists, allergists, immunologists, psychologists, therapists including PT/OT/Speech/CBT may be warranted. Alternative therapies such as craniosacral therapy, chiropractic care, and acupuncture are also used. However, there is a lack of knowledge among the general healthcare community on this syndrome, and families are faced with obstacles in getting proper assessment and treatment.
Seek a Holistic Pediatrician for Proper PANS/PANDAS Treatment
Therefore, building a PANS/PANDAS literate healthcare team is crucial in supporting the child and their family as children and families are often misunderstood, dismissed, overwhelmed, and scared. Integrative practitioners like holistic pediatricians understand the multi-faceted approach required to treat PANS/PANDAS.
At CentreSpringMD we understand this is an auto-immune disorder that requires individualized care. We put gut-immune and detox support as a priority, because diet and environmental factors often exasperate flairs and weaken the immune system in these children. We include parents in the decision-making process and try to work through difficulties.
If you believe your child may be suffering from PANS/PANDAS, don’t hesitate to give us a call at (404) 814-9808, or schedule a virtual visit with a highly skilled holistic pediatrician at CenterSpringMD and get your child back to feeling better sooner.