A sudden behavioral change or a worsening of symptoms in their child’s behavior is why people fly in from all over the US and the world to see me every week. Most parents struggle to find the answers and proper care for PANS/PANDAS.
It can be overwhelming to see your child suffer from PANS/PANDAS. Every parent should understand what Pediatric Acute Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) are to be knowledgeable about the PANS test and treatment plans.
PANS and PANDAS are complex conditions. Parents need the proper knowledge, tools, and support to navigate this challenging path. If you suspect your child might suffer from these conditions, don’t hesitate to ask for a related PANS test and seek professional guidance from a PANS/PANDAS expert.
What are PANS and PANDAS?
PANS is a medical disorder characterized by the sudden onset of symptoms such as obsessive-compulsive disorder (OCD), eating disorders, and other severe neuropsychiatric issues. These symptoms often appear rapidly, sometimes overnight. PANDAS is a subset of PANS explicitly linked to streptococcal infections, like strep throat and scarlet fever.
PANS/PANDAS can result from various infectious triggers. In addition to strep bacteria, other usual sources include Lyme disease, Mycoplasma pneumonia, and viral infections. The immune system's misdirected immune response to these infections is thought to cause inflammation in the brain, particularly in areas like the basal ganglia, affecting the child's behavior and emotions.
Symptoms of PANS/PANDAS
Children with PANS/PANDAS often display a dramatic onset of obsessive-compulsive disorder and other symptoms, including:
- Separation anxiety
- Contamination fears
- Behavioral regression
- Purposeless movements
- New obsession with body image or food intake
- Dramatic changes in school performance
- Uncontrolled emotions
- Sudden onset of OCD symptoms
The PANS Test: Diagnosing the PANS and PANDAS Syndrome
Diagnosing these conditions can be challenging, often requiring a diagnosis of exclusion. According to Prato et al. (2021), a multidisciplinary approach involving medical, psychiatric, and educational professionals is needed to address the diverse needs of children with PANS/PANDAS. Here’s a breakdown of the PANS test and assessment process:
1. Medical History and Family History
We gather comprehensive information about the child’s medical and family history. This helps identify any genetic predisposition or previous streptococcal infections. Additionally, understanding family medical history can reveal patterns that might contribute to the child's health and help tailor the treatment plans.
2. Physical Examination and Lab Work
A thorough physical examination and lab work are essential. Blood tests can help identify specific autoimmune markers. This step is crucial for detecting underlying medical conditions and guiding the proper diagnosis and treatment options.
3. Throat Culture and Rapid Strep Tests
A throat culture or rapid strep test checks for a strep infection. A history of recent strep throat or scarlet fever can be a critical clue. Early detection of strep bacteria through these tests is vital for preventing complications and starting timely treatment plans.
4. Diagnostic Criteria
Diagnosis relies on identifying a dramatic onset of OCD or other severe neuropsychiatric symptoms following an infection. This includes assessing symptoms such as urinary frequency, behavioral regression, and uncontrolled emotions.
5. Lab Tests
Additional laboratory tests include checking for other infectious diseases like Lyme disease or viral infections that could act as triggers. These lab tests are essential for identifying potential infectious triggers and ensuring a comprehensive evaluation of the child's medical conditions.
6. External Assessment
Sometimes, specialized tests like the Cunningham panel or involvement in clinical trials might be recommended for further evaluation. These assessments can provide deeper insights into the child's condition and help refine the diagnostic criteria for more targeted treatment options.
PANS/PANDAS Treatment and Support
Treatment for PANS/PANDAS often involves a combination of approaches:
- Antibiotics: Used to address the underlying strep infection or other infectious triggers.
- Cognitive Behavioral Therapy (CBT): Effectively manages stress and behavioral issues.
- Exposure and Response Prevention: Techniques to help manage OCD and anxiety-related behaviors.
- Immune Modulation: In some cases, treatments to modulate the immune system might be necessary.
- Interventions: Severe cases might require more intensive interventions, but with the proper support and treatment options, many children can regain normal function and improve their quality of life.
One study focused on using Cognitive-Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) to augment antibiotic treatments for PANDAS. The case involves a 12-year-old boy who experienced significant improvements in his OCD symptoms and overall functioning after receiving CBT and ACT in addition to antibiotic treatment (Pozza, 2017).
The Dr. Roseann Natural PANS/PANDAS Calm Brain Kit is created to support you through this journey. This comprehensive resource includes detailed guides on symptoms and diagnosis. Use it to understand the diagnostic criteria and symptoms for early detection and intervention.
It also contains information on various assessment options and how to work with medical professionals to get a proper diagnosis. An overview of available treatment plans, including antibiotics, cognitive behavioral therapy (CBT), and other therapeutic approaches, are also explained.
We also added tips on managing your child's school performance and behavior at home and how to access and build support networks by connecting with other parents and healthcare providers who understand your situation. It’s your ultimate guide for the PANS test to help you obtain the necessary lab work and laboratory tests.
Grab the Dr. Roseann PANS and PANDAS Parent here to begin your journey to healing from PANS/PANDAS.
When did PANS become a clinical diagnosis?
PANS and PANDAS became recognized as clinical diagnoses in the late 1990s and early 2000s. PANDAS was initially proposed in 1998 by Dr. Susan Swedo and her colleagues at the National Institute of Mental Health (NIMH).
Can rheumatic fever cause PANS and PANDAS?
Yes, rheumatic fever, an inflammatory disease that can develop after a strep throat infection, has been associated with PANDAS due to its connection with streptococcal infections. While PANS encompasses a broader range of triggers beyond strep infections, rheumatic fever can contribute to the development of neuropsychiatric symptoms in susceptible individuals.
Is there a specific age group affected by PANS and PANDAS?
PANS and PANDAS can affect children of any age, but they often manifest in early childhood or adolescence. However, cases in adults have also been reported, although less frequently.
Can dietary changes or nutritional supplements help manage the symptoms of PANDAS?
Some parents have reported improvements in their child's symptoms with dietary modifications, such as eliminating gluten or dairy and supplements like omega-3 fatty acids or probiotics. However, it's essential to consult with a healthcare professional before making any significant changes to your child's diet or supplement regimen.
Are there any long-term effects or complications associated with PANDAS?
Long-term effects of PANDAS can vary depending on factors such as the severity of symptoms, effectiveness of treatment, and individual differences. Some children may experience lingering neuropsychiatric symptoms or cognitive challenges, while others may fully recover with appropriate intervention.
How can parents advocate for their child's educational needs with PANDAS?
Parents can work with their child's school to develop a 504 or individualized education plan (IEP) to accommodate their educational needs. Providing the school with information about PANDAS, including symptoms, triggers, and potential academic impacts, can help teachers and administrators better support the child.
How can parents further support a child with PANS or PANDAS?
Parents can support their children by seeking early intervention, advocating for appropriate medical care, and educating themselves about PANS/PANDAS. Establishing a supportive environment at home, maintaining open communication, and connecting with support groups can also benefit the child and the family.
Citations
Pozza, A. (2017). Cognitive behavioral therapy and acceptance and commitment therapy as augmentation treatment for paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS): A case report. European Psychiatry, 41(S1), S781–S782. https://doi.org/10.1016/j.eurpsy.2017.01.1488
Prato, A., Gulisano, M., Scerbo, M., Barone, R., Vicario, C. M., & Rizzo, R. (2021). Diagnostic Approach to Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections (PANDAS): A Narrative Review of Literature Data. Frontiers in Pediatrics, 9. https://doi.org/10.3389/fped.2021.746639
Dr. Roseann is a mental health expert in PANS/PANDAS who frequently is in the media:
- Healthy Parenting Connector (Video) Why “My Kid is Acting Crazy” Might be PANS/PANDAS
- Living with Lyme (Podcast) Neurofeedback and biofeedback for PANS/PANDA
- Maria Rickert Hong (Audio) PANS/PANDAS
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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Dr. Roseann is a Children’s Mental Health Expert and Licensed Therapist who has been featured in/on hundreds of media outlets including The Mel Robbins Show, CBS, NBC, PIX11 NYC, Today, FORBES, CNN, The New York Times, The Washington Post, Business Insider, Women’s Day, Healthline, CNET, Parade Magazine and PARENTS. FORBES called her, “A thought leader in children’s mental health.”
She coined the terms, “Re-entry panic syndrome” and “eco-anxiety” and is a frequent contributor to media on mental health.
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.
She is the author of three bestselling books, It’s Gonna Be OK!: Proven Ways to Improve Your Child's Mental Health, The Teletherapy Toolkit, and Brain Under Attack. Dr. Roseann is known for offering a message of hope through science-endorsed methods that promote a calm brain.
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