PANS and PANDAS are treatable, but a child’s response to therapy depends on a number of factors and early intervention is absolutely a key component in any treatment plan. Symptoms may vary from one patient to another, which further compounds the complexity of making a diagnosis and beginning the appropriate treatment.
At MindWell Center for PANS & PANDAS our initial consultation begins with a thorough review of any and all existing medical histories as well as parent or caregiver observations. Since PANS, PANDAS, and other related neuroimmune disorders also may present with other concurrent conditions, we review these documented records in order to make the most complete assessment that includes participating clinician protocols. Integrative medicine considers the total picture of a patient’s health in order to design a treatment plan that optimizes success and does not compromise the value of other appropriate care |
Assessment and diagnosis.
As there are no disease-specific laboratory tests available, the diagnosis (and subsequent treatment) of PANS PANDAS is a clinical diagnosis based on established medical criteria for same. However, there are a number of labs that we use to aid in making the diagnosis such as:
Other tools that are considered for diagnostic purposes may include:
Mold evaluation
Heavy metal evaluation
Lyme testing
Throat and/or nasopharyngeal swab for M. pneumoniae PCR
PCR-DNA stool study
Food sensitivity and allergen assessments
Environmental review for potential strep carriers in close contact and other factors that can influence or instigate symptoms
These are just some of the assessment activities included in our patient approach that is unique to each case and set of symptoms. Other tests may be ordered as appropriate and determined to be necessary during the total treatment process.
As there are no disease-specific laboratory tests available, the diagnosis (and subsequent treatment) of PANS PANDAS is a clinical diagnosis based on established medical criteria for same. However, there are a number of labs that we use to aid in making the diagnosis such as:
- Complete blood count study and urine analysis
- Antinuclear antibody panels
- Thyroid profile
- Additional laboratory work including several blood level tests for the presence of antibodies, biomarkers, titer profiles to identify presence of specific bacteria such as streptococcus, levels of specific nutrients like vitamin D and magnesium, Western blot analysis, and similar tests.
- Imaging studies as warranted (MRI, NeuroQuant, PET scan, etc.)
- The Cunningham panel - The Cunningham panel by Moleculera Labs is a series of tests designed help physicians diagnose and treat infection-induced neuropsychiatric disorders. These tests measure circulating levels of auto-antibodies directed against specific neuronal antigens; if any of these antibodies is elevated, this is an indication of autoimmunity. Note that the Cunningham panel only establishes autoimmunity, not what is causing the autoimmunity. Additional testing is necessary to determine the cause of autoimmunity.
Other tools that are considered for diagnostic purposes may include:
Mold evaluation
Heavy metal evaluation
Lyme testing
Throat and/or nasopharyngeal swab for M. pneumoniae PCR
PCR-DNA stool study
Food sensitivity and allergen assessments
Environmental review for potential strep carriers in close contact and other factors that can influence or instigate symptoms
These are just some of the assessment activities included in our patient approach that is unique to each case and set of symptoms. Other tests may be ordered as appropriate and determined to be necessary during the total treatment process.
Our treatment approach.
The PANS Research Consortium of immunologists, rheumatologists, neurologists, infectious disease experts, general pediatricians, psychiatrists, nurse practitioners, and other scientists published its three-part recommendations in a special issue of the Journal of Child and Adolescent Psychopharmacology. This report covers psychiatric and behavioral interventions specific to the syndromes’ symptoms and also discusses immunomodulatory therapy and details regarding infections in the disorders.
Our practice follows the Consortium guidelines that include in part:
Learn more about our total patient approach and what your first visit entails.
The PANS Research Consortium of immunologists, rheumatologists, neurologists, infectious disease experts, general pediatricians, psychiatrists, nurse practitioners, and other scientists published its three-part recommendations in a special issue of the Journal of Child and Adolescent Psychopharmacology. This report covers psychiatric and behavioral interventions specific to the syndromes’ symptoms and also discusses immunomodulatory therapy and details regarding infections in the disorders.
Our practice follows the Consortium guidelines that include in part:
- treatment of any underlying infection to remove inflammation source(s)
- immunomodulatory therapy/IVIg (intravenous immunoglobulin infusions)
- removal and/or reduction of environmental factors that can contribute to symptoms (toxins, metals, mold, plastics and other potential health detriments)
- neuro-rehabilitation therapies and neurofeedback activities
- cognitive behavioral therapy (CBT)
- family support practices and resources
- nutritional program design focused on an autoimmune, paleo diet with elimination of gluten, dairy and all forms of sugar as well as processed foods containing additives, chemicals, dyes or other potential triggers and identified allergens
Learn more about our total patient approach and what your first visit entails.