Having a child with PANDAS or PANS can be overwhelming as there are many questions and concerns about these conditions, especially with the absence of qualified providers. Such absence is why people fly in to see me from all over the world.
We always start a QEEG brain map and an intake, so that we can be sure about what the next steps are. That information is critical in our PANS/PANDAS planning and strategy session.
Understanding the differences and similarities in treatments is essential for effectively managing these conditions. It can be confusing understanding the complexities of PANDAS treatment versus PANS treatment, so I work to provide parents with the information they need to navigate these challenging disorders.
Understanding PANS and PANDAS
PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) are conditions that lead to abrupt, severe neuropsychiatric symptoms. The primary difference is that PANDAS is triggered explicitly by a strep infection, while PANS can be triggered by various infections, including Lyme disease, mycoplasma, or environmental factors.
How Are PANS and PANDAS Treatments Similar?
PANDAS and PANS involve treatments that address the underlying infections and inflammation in the brain. These treatments often include:
- Antibiotics: These are used to treat the bacterial infections causing pandas or PANS symptoms. In the case of PANDAS, antibiotics target the streptococcal infection.
- Anti-inflammatory medications: Non-steroidal anti-inflammatory drugs (NSAIDs) or steroids are used to reduce neuroinflammation.
- Immunomodulatory therapies: The standard therapies include intravenous immunoglobulin (IVIG) or plasmapheresis, which help modulate the immune system's response.
- Behavioral therapies: To manage neuropsychiatric symptoms like OCD, anxiety, and tics. Cognitive-behavioral therapy (CBT) can be particularly beneficial.
These treatments aim to alleviate the acute symptoms and prevent future episodes by addressing the root cause of the neuroinflammation.
How Are PANS and PANDAS Treatments Different?
While the core PANS and PANDAS treatments are similar, the primary difference lies in the identification and management of the triggers:
PANDAS Treatment
- Focus on Streptococcal Infection: Treatments center around eradicating the streptococcal infection and preventing future infections. This often involves long-term antibiotic prophylaxis.
- Tonsillectomy Consideration: A tonsillectomy might be considered in cases of recurrent strep throat. Some parents ask, “Can you get strep without tonsils?” Yes, even without tonsils, strep infections can still occur.
- Behavioral Interventions: Specific focus on managing sudden-onset OCD and tics triggered by strep.
PANS Treatment
- Broad Infection Management: Treatment involves identifying and addressing a variety of possible triggers, including Lyme disease, mycoplasma, and environmental factors.
- Holistic Approach: Emphasis on detoxification and nutritional support to address multiple infections and toxins.
Environmental Modifications: Implementing changes to reduce exposure to potential environmental triggers
PANS and PANDAS Diagnosis
Children suffering from PANS/PANDAS often face a challenging array of symptoms due to multiple toxins and infections contributing to their neuroinflammation. This multifaceted issue means the treatment approach must be thorough and holistic, addressing all possible underlying causes.
One study examined PANS' pathophysiology, clinical presentation, and treatment options. It discusses the role of infections, autoimmunity, and neuroinflammation in developing PANS symptoms. It emphasized the need for comprehensive diagnostic evaluations and individualized treatment plans to address the complex nature of PANS (Cabrera-Mendoza et al., 2019).
PANS and PANDAS Syndrome Comprehensive Testing
One of the first steps in managing PANS/PANDAS is to conduct comprehensive testing to identify all potential infections and toxins contributing to the condition. This isn't just a single test but a series of evaluations to provide a complete picture of the child's health. These tests may include:
- Blood Tests: Blood work is essential to detect bacterial or viral infections, inflammatory markers, and immune system activity. Specific tests can identify the presence of streptococcal bacteria, which is crucial in diagnosing PANDAS and other pathogens that might trigger PANS.
- Urine Tests: Urinalysis can help identify metabolic imbalances and the presence of certain toxins or infections. It provides additional data that complements blood test results.
- Imaging Studies: In some cases, imaging studies like MRI or CT scans might be necessary to rule out other neurological conditions and assess the extent of neuroinflammation.
Detoxification
Once comprehensive testing has identified the presence of toxins and infections, the next step is detoxification. This process is crucial for removing environmental toxins and heavy metals that may exacerbate neuroinflammation. Detoxification strategies may include:
- Chelation Therapy: This medical procedure involves administering chelating agents to remove heavy metals from the body. It is used when tests reveal high metals like lead or mercury.
- Nutritional and Herbal Supplements: Certain supplements can support the body's natural detoxification processes. For example, glutathione, a powerful antioxidant, helps neutralize toxins.
- Hydration: Ensuring adequate hydration helps the body flush out toxins through urine.
- Sauna Therapy: Some parents find that sauna therapy, which induces sweating, helps eliminate toxins through the skin.
Nutritional Support
A well-balanced diet supports the immune system and overall health, particularly for children with PANS/PANDAS. Nutritional support focuses on:
- Anti-inflammatory Diet: Incorporating foods that reduce inflammation, such as leafy greens, fish rich in omega-3 fatty acids, nuts, and seeds, can help manage neuroinflammation.
- Probiotics: Since gut health is closely linked to immune function, incorporating probiotics can help maintain a healthy gut microbiome. This can be achieved through fermented foods like yogurt, kefir, sauerkraut, and supplements.
- Elimination of Potential Triggers: Identifying and eliminating foods that may trigger inflammation or allergic reactions is essential. Common culprits include gluten, dairy, and processed sugars.
Nutrient-Rich Foods: Ensuring the child receives adequate vitamins and minerals, particularly those known to support brain health, such as vitamin D, B vitamins, and magnesium, is crucial.
Holistic and Integrative Approach
Managing PANS/PANDAS requires a holistic and integrative approach beyond conventional treatments. This approach considers the child's physical, emotional, and psychological well-being.
- Regular Monitoring and Adjustments: As children respond to treatments, regular follow-ups, and adjustments to their care plan are necessary to ensure continued progress and address any new issues.
- Mental and Emotional Support: Given the neuropsychiatric nature of PANS/PANDAS, working with mental health professionals who understand these conditions is essential. This might include cognitive-behavioral therapy (CBT), family therapy, and supportive counseling.
- Educational Support: Collaborating with schools to ensure that children receive the necessary accommodations and support can help them succeed academically and socially.
By adopting a comprehensive, multidisciplinary approach to diagnosis and treatment, parents can better manage the complexities of PANS/PANDAS. This strategy addresses the immediate symptoms and promotes long-term health and well-being. Remember, the journey may be challenging, but with the proper knowledge and support, you can help your child thrive.
To help empower your child with PANS and PANDAS and help them achieve a calm brain without relying on medication, your next step is to get my Natural Pans/Pandas Calm Brain Kit. I created this for parents like you who need accurate information and a clear understanding of how to treat PANS/PANDAS.
What is PANDAS disease?
PANDAS disease stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. It's a condition where a streptococcal infection triggers sudden-onset neuropsychiatric symptoms in children, such as OCD, tics, anxiety, and behavioral changes. This autoimmune response affects the basal ganglia in the brain, leading to the characteristic symptoms of PANDAS.
What is PANS disease?
PANS disease, or Pediatric Acute-onset Neuropsychiatric Syndrome, is a condition characterized by the sudden onset of neuropsychiatric symptoms such as OCD, anxiety, tics, and behavioral changes in children. Unlike PANDAS, which is explicitly triggered by streptococcal infections, PANS can be associated with various diseases, environmental factors, or metabolic disturbances. This syndrome is believed to involve an autoimmune response and neuroinflammation, leading to the sudden onset of symptoms.
Are PANDAS dangerous?
Yes, if left untreated, PANDAS can lead to severe neuropsychiatric symptoms and significantly impact a child's quality of life. The sudden onset of symptoms such as OCD, tics, anxiety, and behavioral changes can be distressing for both the child and their family. Early and appropriate treatment is crucial to managing PANDAS effectively and minimizing its impact on the child's well-being.
Why do I keep getting strep throat?
Strep throat can recur if the initial streptococcal infection is not entirely eradicated or if there is repeated exposure to the bacteria. Persistent infections can also be due to immune system issues or if others in close contact are carriers of strep bacteria.
Can you get strep without tonsils?
Yes, it is possible to get strep throat even if you've had your tonsils removed. Strep throat is caused by the Streptococcus bacteria, which can infect the throat and surrounding tissues regardless of whether the tonsils are present. Therefore, the absence of tonsils does not eliminate the risk of contracting strep throat.
How long does strep last?
Without treatment, strep throat can typically last for about a week. However, with appropriate antibiotic treatment, symptoms usually improve within 24 to 48 hours. To ensure the infection is eradicated, it's essential to complete the entire course of antibiotics prescribed by your healthcare provider, even if symptoms improve before the medication is finished.
Citation
Cabrera-Mendoza, B., Genis-Mendoza, A. D., & Nicolini, H. (2019). Diagnosis in PANDAS: An Update. Current Psychiatry Research and Reviews Formerly: Current Psychiatry Reviews, 15(4), 237–247. https://doi.org/10.2174/2666082215666190917161514
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Disclaimer: This article is not intended to give health advice and it is recommended to consult with a physician before beginning any new wellness regime. *The effectiveness of diagnosis and treatment vary by patient and condition. Dr. Roseann Capanna-Hodge, LLC does not guarantee certain results.
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Dr. Roseann Capanna-Hodge has three decades of experience in working with children, teens and their families with attention-deficit hyperactivity disorder (ADHD), autism, concussion, dyslexia and learning disability, anxiety, Obsessive Compulsive Disorder (OCD), depression and mood disorder, Lyme Disease, and PANS/PANDAS using science-backed natural mental health solutions such as supplements, magnesium, nutrition, QEEG Brain maps, neurofeedback, PEMF, psychotherapy and other non-medication approaches.
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