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Families facing sudden behavioral or neurological changes in their child often feel overwhelmed trying to understand which treatments are appropriate and why symptoms escalate so quickly. PANDAS treatment specifically focuses on addressing strep-triggered autoimmune inflammation, often using antibiotics, anti-inflammatory support, immune therapies, and nervous system regulation strategies. PANS treatment is broader because PANS can be triggered by infections, viruses, toxins, metabolic issues, or environmental stressors, requiring treatment to target the child’s specific root cause.

I’m Dr. Roseann Capanna-Hodge, and throughout my 30+ years of clinical work, I’ve supported children dealing with complex neuroimmune disorders that affect behavior, cognition, and emotional regulation. I know how confusing treatment decisions can feel for parents, and I’m passionate about helping families better understand root-cause approaches that support long-term healing and regulation.

What You’ll Learn

• The key differences between PANS and PANDAS treatment plans.
• Why identifying infection triggers changes treatment recommendations.
• Common therapies used to reduce inflammation and support recovery.

What Are PANDAS and PANS?

PANDAS and PANS can suddenly change how a child acts—like having OCD, anxiety, tics, or even big outbursts. The big difference is what causes them.

• PANDAS happens after a strep infection like strep throat.
• PANS can be caused by other things like Lyme disease, a virus, or even something in the environment.

These conditions are sometimes missed or misunderstood, which means kids don’t get help fast enough. But with the right treatment, kids can feel like themselves again.

Symptoms Checklist for PANS AND PANDAS

It’s important for parents to know what causes PANDAS and PANS, because it helps them choose the right treatment. Both start after the body reacts to an infection, but the type of infection can be different.

PANDAS:

• Caused by a streptococcal infection, such as strep throat or scarlet fever.
  
• The body’s immune response to the infection attacks the brain, leading to neuropsychiatric symptoms.
  

PANS:

• Triggered by a broader range of infections (viruses, bacteria) or other immune system triggers like Lyme disease or even environmental factors (e.g., toxins, stress).
  

Symptoms appear suddenly, often after an infection or stressor.

Symptoms Checklist for Both Conditions:

• Sudden onset of severe anxiety        
• Obsessive-compulsive behaviors (OCD)        
• ‍Motor tics        
• Severe mood swings      
•  Decline in academic performance        
• Regression in behaviors (e.g., bed-wetting, tantrums)        
• Sleep disturbances

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What Are the Treatment Options for PANDAS?

Treating PANDAS requires a multifaceted approach, aimed at addressing both the infection and the immune response that causes the neuropsychiatric symptoms.

1. Antibiotic therapies

• First-line treatment: Antibiotics to target the streptococcal infection. Common options available are penicillin or amoxicillin.
  
• Long-term antibiotic therapy may be necessary for children who experience recurring symptoms after initial treatment.

2. Immunomodulatory treatments

• In cases where antibiotics alone don’t help, doctors may recommend steroid treatments or IVIG (Intravenous Immunoglobulin), which can reduce inflammation and modulate the immune system.

3. Behavioral and psychiatric interventions

• While treating the infection and immune response is crucial, behavioral interventions are essential for helping children cope with symptoms. Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) are effective for treating OCD symptoms and anxiety.

What Are the Treatment Options for PANS?

Since PANS can be triggered by a variety of infections, treatment focuses on identifying and addressing the underlying trigger while managing the psychiatric symptoms.

1. Identification of underlying triggers

• Blood tests and other diagnostic tests can help identify bacterial, viral, or autoimmune triggers for PANS.

2. Anti-inflammatory treatments

• Anti-inflammatory medications, such as NSAIDs or corticosteroids, can help reduce brain inflammation that may be contributing to the neuropsychiatric symptoms.

3. Comprehensive therapeutic strategies

• As with PANDAS, PANS treatment may include antibiotics, immune-modulating therapies, and behavioral treatments (CBT, ERP).
• IVIG may also be used in severe cases to reduce inflammation and improve symptoms.
• Nervous system regulation—through therapies like PEMF, mindfulness, or sensory-based interventions—can also help restore balance.

How Are PANDAS and PANS Treatments Different?

While PANDAS and PANS share many similarities, treatment protocols differ based on their underlying causes.

Case Study: Maya’s PANDAS Treatment and Recovery

Maya was a thriving child until a tick bite at age 6 led to a downward spiral—focus issues, bladder control problems, and sleep struggles. A strep infection a year later triggered sudden rage and extreme emotional shifts, leading to years of misdiagnosis and psychiatric medications that didn’t help.

Eventually, a PANS specialist uncovered multiple infections and toxic mold exposure, but after a viral flare, Maya’s parents turned to our for deeper healing.

Her QEEG Brain Map showed significant inflammation, keeping her brain stuck in fight-or-flight mode.

Her custom plan included:

• Neurofeedback therapy to regulate brain activity
• PEMF and biofeedback to support cellular repair
• Targeted detox and supplements for infection and mold recovery
  Parent coaching and somatic therapy to support co-regulation at home
  

Maya’s Results:

• Emotional outbursts dropped from 3 per day to 1 every 7–10 days
• Brainwave activity significantly decreased
• Improved sleep, mood, and connection with family and school

Today, Maya is laughing again, making friends, and enjoying family dinners—something her parents thought might never happen again.

Every child’s path is unique, but with the right treatments and a focus on nervous system regulation, real progress happens. There is hope—and your child can heal.

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 and manage their child's symptoms of PANS/PANDAS.

Why Is an Accurate Diagnosis Essential for Effective Treatment?

An accurate diagnosis is crucial because treatment plans for PANDAS and PANS can vary significantly.

For example, if a child’s symptoms are misdiagnosed as another disorder (such as ADHD or anxiety), they may not receive the appropriate treatment.

By accurately identifying whether the cause is autoimmune, infection-related, or something else, parents and healthcare providers can tailor the treatment plan to suit the child’s unique needs.

A misdiagnosis can delay the child’s healing and exacerbate their symptoms. Additionally, understanding whether the condition is PANDAS or PANS allows for the correct choice of antibiotics, immune treatments, and other interventions.

Read more about: Causes, Symptoms, and Treatment for PANS/PANDAS

Parent Action Steps

☐ Keep things low stress at home        

☐ Track how your child’s symptoms progress      

☐  Consult with a trusted healthcare provider about possible infections        

☐ Explore both medication and psychotherapy-based solutions            

☐ Not sure where to start? Take our FREE Brain and Behavior Solutions Matcher Quiz

Frequently Asked Questions

What is the main difference between PANS and PANDAS treatment?

The main difference between PANS and PANDAS treatment is that PANDAS treatment targets strep-related triggers while PANS treatment looks for broader immune triggers.

Does PANDAS always require antibiotics?

No, PANDAS does not always require antibiotics, but antibiotics may help when strep infection is involved.

Can PANS be treated if the trigger is not strep?

Yes, PANS can be treated even if the trigger is not strep by identifying and addressing the specific immune or environmental trigger.

Why do PANS and PANDAS treatments both focus on inflammation?

PANS and PANDAS treatments both focus on inflammation because inflammation can drive OCD, anxiety, tics, and behavioral symptoms.

What therapies support both PANS and PANDAS recovery?

Therapies that support both PANS and PANDAS recovery include ERP, CBT, neurofeedback, nutrition support, and nervous system regulation.

Can IVIG be used for both PANS and PANDAS?

Yes, IVIG can be used for both PANS and PANDAS in severe immune-driven cases when medically appropriate.

Why is lab testing important for PANS and PANDAS treatment?

Lab testing is important for PANS and PANDAS treatment because testing can identify infections, inflammation, toxins, or nutrient deficiencies.

How do parents know which treatment path is right?

Parents can know which treatment path is right by working with a provider to evaluate triggers, symptoms, lab findings, and treatment response.

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Bella, S., Scorrano, G., Rinaldi, M., Di Ludovico, A., Mainieri, F., Attanasi, M., Spalice, A., Chiarelli, F., and Breda, L. (2023). Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS): myth or reality? The state of the art on a controversial disease. Microoganisms, 11(10):2549. https://doi.org/10.3390/microorganisms11102549.

Brown, K., Farmer, C., Freeman JR., G Mark., Spartz, E., Farhadian, B., Thienemann, M., and Frankovich, J. (2017). Effect of early and prophylactic nonsteroidal anti-inflammatory drugs on flare duration in Pediatric Acute-Onset Neuropsychiatric Syndrome: and observational study of patients followed by an academic community-based Pediatric Acute-Onset Neuropsychiatric Syndrome clinic. J Child Adolesc Psychopharmacol, 27(7):619-628. https://doi.org/10.1089/cap.2016.0193.

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

Melamed, I., Rahman, S., Pein, H., Heffron, M., Frankovich, J., Kreuwel, H., and Mellins, E. (2024). IVIG response in Pediatric Acute-Onset Neuropsychiatric Syndrome correlates with reduction in pro-inflammatory monocytes and neuropsychiatric measures. Front Immunol. 15:1383973. https://doi.org/10.3389/fimmu.2024.1383973

Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): Clinical Report. (2025). Pediatrics, 155(3).https://doi.org/10.1542/peds.2024-070334.

Dr. Roseann is a mental health expert in PANS/PANDAS who frequently is in the media:

• Parenting beyond the headlines Podcast Talking About PANS, PANDAS and Autoimmune Encephalitis
• Therapy Chat (Podcast) The Trauma Of PANS/PANDAS, AE + Neuroinflammation With Dr. Roseann Capanna-Hodge
• Learning to Slay the Beasts (Podcast) Treating PANDAS, PANS, and Lyme with Dr. Roseann Capanna-Hodge

Always remember... “Calm Brain, Happy Family™”

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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