PANS and PANDAS
PANS and PANDAS are autoimmune immune induced inflammatory conditions that results when an infection or some other invasive trigger spurs the body to turn on itself and attack structures in the brain resulting in sudden or subacute neuro-psychiatric changes such as the sudden onset of severe obsessive compulsive disorder, motor tics, anxiety, eating restrictions , behavioral regression and other symptoms. Today, it is estimated that these conditions occur in 1 in 150 children.
PANS is the acronym for Pediatric Acute-onset Neuropsychiatric Syndrome, a disorder that encompasses the more familiar medical condition, PANDAS or Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections. PANDAS is now considered a subset of the broader classification, PANS, both of which are acute-onset disorders that afflict children of many ages and with a broad range of symptoms. It’s called “acute onset” because the associated behavior changes come on very suddenly, reaching full-scale intensity within 24 to 48 hours. Given the disparity of symptoms and the rate at which they manifest, many children are often misdiagnosed as having psychiatric disorders and subsequently do not receive the appropriate treatment in a timely manner.
If the onset of these symptoms is linked to a strep infection, the diagnosis is then one of PANDAS. In the absence of a strep-associated illness or other type of preceding infection, then your doctor will diagnose the illness as PANS. From a symptoms perspective, parents may see their children develop almost overnight a series of significant changes in a variety of behaviors. These behaviors can vary widely from one child to another, but can include:
-mood changes or dramatic mood swings
-obsessive compulsive behaviors
-tics or involuntary movements
-changes in eating or dietary practices (suddenly refusing to eat a favorite food or limiting food intake entirely)
-separation and other anxieties
-irritability and oppositional defiance
-decline in school performance
-changes in social interactions with friends, family, teachers and other individuals
-motor or sensory abnormalities
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.
What Parents 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 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 physician with a complete history as far as when the behaviors began, any illness that preceded this, any new environmental settings or possible exposure to toxins or interaction with children who may have had a strep or similar infection, any laboratory or other testing you may obtain from an urgent care or emergency facility and similar details. 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.
Some physicians do not recognize PANS and PANDAS as an excepted diagnosis, but, the research and science that has been done for the last 20 years strongly supports the neuro-immune mediated mechanisms involved in these conditions. Rogue immunity with multiple environmental and infectious triggers is now linked to many neurological and psychiatric problems including neurodegenerative diseases like Alzheimer’s disease, autism, depression and even schizophrenia.