Estimated reading time: 6 minutes
PANS and PANDAS have a lot in common, but when it comes to treatment, understanding the differences is essential.
Parenting a child with one of these conditions can feel like navigating a maze of misinformation, especially when reliable answers are so hard to find. As a fellow PANS mom, I understand the frustration, fear, and exhaustion that comes with trying to help your child.
Let’s break down the key differences between PANDAS treatment and PANS treatment,so you can feel more confident, informed, and empowered on your child’s healing journey.
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:
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.
| Aspect | PANDAS Treatment | PANS Treatment |
|---|---|---|
| Primary Trigger | Streptococcal infection | Various infections (Lyme disease, mycoplasma), environmental factors |
| Initial Treatment | Antibiotics specifically targeting strep (e.g., penicillin, amoxicillin) | Broad-spectrum antibiotics or antivirals, depending on the identified trigger |
| Inflammation Management | NSAIDs, corticosteroids, and sometimes immunomodulatory therapies like IVIG | A similar anti-inflammatory approach, with a focus on identifying and treating all sources of inflammation |
| Prophylaxis | Long-term antibiotics to prevent recurrent strep infections | Regular monitoring and treatment of identified diseases, environmental modifications |
| Additional Therapies | Cognitive-behavioral therapy (CBT), psychiatric medications for OCD and tics | Similar psychiatric support, plus detoxification protocols and nutritional interventions |
| Surgical Options | Tonsillectomy is considered in cases of recurrent strep throat | Not typically a consideration unless there is a clear anatomical issue contributing to recurrent infections |
| Holistic Approach | Integration of holistic and environmental interventions with other treatments | Strong focus on holistic care, including dietary changes, detoxification, and reducing ecological toxin exposure |
| Symptom Focus | Sudden-onset OCD, tics, and other neuropsychiatric symptoms | Similar neuropsychiatric symptoms, with an additional focus on broader systemic health due to varied triggers |
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 BrainBehaviorReset™ Program 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.
Parent Action Steps
Frequently Asked Questions
Is PANDAS Syndrome Permanent?
No, PANDAS is not necessarily permanent. With early intervention and proper treatment, many children experience significant improvement or even full recovery.
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.
How Long After a Strep Infection Do PANDAS Symptoms Appear?
PANDAS symptoms typically develop suddenly within a few days to a few weeks after a strep infection.
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.
Citation
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.2024.1283973.
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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