Pediatric Autoimmune Neuropsychiatric Disorders (PANDAS) occurs when a Streptococcal infection triggers a misdirected immune response which causes inflammation in a child’s brain. As a result, the child begins to exhibit life-changing symptoms such as OCD, anxiety, tics, personality changes, sensory sensitivities, restrictive eating, and more.

The root cause of PANDAS is still considered unknown. However, the science behind the way in which the strep cells attack the body is clear.

The process in which PANDAS occurs is called “molecularly mimicry” as strep bacteria hide in the body by putting molecules on their cell walls in order to evade the body’s immune system. As the strep cells have been able to spread undetected for an extended period, they have often made their way to the child’s heart, joints, skin, and brain tissues. Because the strep bacteria have become nearly identical to the child’s cells when the immune system identifies them as foreign, antibodies attack not only the strep cells, but also the child’s own cells. Therefore, critical areas such as the brain are attacked and inflamed altering the child’s brain chemistry.

The symptoms of PANDAS typically begin suddenly, anywhere from four to six weeks after a strep infection has occurred. Often, the symptoms are similar to behaviors experienced by those with obsessive-compulsive disorder (OCD) and Tourette syndrome. However, opposed to other psychological disorders, the symptoms of PANDAS peak in severity within 2-3 days after they begin.

An indicator of PANDAS is often a radical shift in a child’s behavior or performance in school. PANDAS is frequently accompanied by a dramatic decrease in performance, given the child’s brain chemistry has been affected by this condition. Although PANDAS primarily affects the brain, due to the interconnectivity of the body, symptoms present in both the psychological and physical form.

Psychological symptoms may include: frequent screaming, irritability, constant changes in mood, obsessive, compulsive, and repetitive behaviors, separation anxiety, general fear, panic attacks, regression in emotional development, visual and/or auditory hallucinations, and depression and suicidal thoughts.

Physical symptoms may include: sensitivities to sensory stimulation, tics or unusual movement, deterioration of small motor skills (often evident with handwriting), inability to focus, refusal to eat, sleeping problems, memory problems, joint pain, and bedwetting.

Diagnosing PANDAS first requires diagnosing the child’s strep infection. To diagnose a strep infection, the doctor may take a throat culture or run a blood test. However, there are no laboratory or neurological tests to diagnose PANDAS. Alternatively, a variety of blood and urine tests may be conducted in order to rule out other conditions.

Although there is not a test for PANDAS, there are criteria for a diagnosis, which include:

● The patient is three years or older but has not yet begun puberty. ● The patient’s symptoms began suddenly and the patient experienced a drastic increase in the severity of symptoms for periods of time. ● The patient presents with tics or obsessive-compulsive behaviors. ● There is evidence of other neuropsychiatric symptoms (anxiety, hyperactivity, depression, mood irregularities, and developmental regression). PANDAS is a serious condition as it can affect a child’s ability to learn and socialize. If gone untreated, PANDAS can result in permanent cognitive damage and even lead to the development of a chronic autoimmune condition.

At Holtorf Medical Group, our physicians are trained to provide cutting-edge testing and innovative treatments to properly diagnose and treat PANDAS, optimize your child’s health, and improve their quality of life. Contact us to see how we can help you!

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