PANS and PANDAS
Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections (PANDAS) are immune-mediated, inflammatory conditions that can occur when an infection or other trigger causes the body to essentially turn on itself and attack structures in the brain. Each of these disorders may manifest in sudden or subacute neuro-psychiatric changes including but not limited to the rapid onset of severe obsessive compulsive disorder (OCD), tics, anxiety, eating restrictions, and often dramatic behavioral changes. This is not a complete list of possible symptoms or signs of PANS or PANDAS so it is always recommended you discuss with your child’s pediatrician any concerns or observations at the earliest opportunity, ideally for referral to a neurology specialist.
Given the disparity of symptoms and the rate at which they present, combined with some practitioners’ lack of familiarity with these illnesses, many children are often misdiagnosed. They may be determined to have a psychiatric disorder, for example, and subsequently do not receive the appropriate treatment in a timely manner…which can mean that parents, guardians or caregivers may have to assume even more of an advocacy role on behalf of the patient.
What you can do.
Since PANS and PANDAS can affect children as young as three or four years old, it is not possible to expect your child to fully verbalize appropriately how they are feeling or explain their changes in behavior. It’s important to note too that not all sudden behavioral shifts can be attributed to one of these disorders so it’s best to provide your child’s physician with a complete history relative to when the behaviors began, any illness that preceded these observed changes, any new environmental settings or possible exposure to toxins or interaction with children who may have had a strep or similar infection. Ideally, you should provide as well any laboratory or other testing you may have obtained from an urgent care or emergency facility and similar documentation. These are not easily diagnosed disorders and there are certain criteria for definitively identifying PANS or PANDAS – so the more information you can provide, the more helpful your insight can be to medical professionals in arriving at the best treatment plan.
We invite you to visit our comprehensive PANS and PANDAS-dedicated section on this website for in-depth information about symptoms, our protocols including assessment, treatment and resources, as well as the latest research news and more.