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What precisely are PANDAS and PANS?

PANDAS and PANS are both infection-induced autoimmune conditions that disrupt a child’s normal neurologic functioning. The symptoms are almost identical, although the etiology for PANS is different from that of PANDAS.

Both PANDAS and PANS can result in a sudden onset of severe OCD (Obsessive Compulsive Disorder) in children. These children can also have severe and sudden irritability, mood swings, anxiety, or uncontrollable movements such as motor tics.

Triggered by infections like Lyme disease, Coxsackie virus and strep, these conditions disrupt a child’s normal neurological functioning. The result is a sudden onset of obsessive-compulsive behaviors and other negative symptoms.

PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection. It is an autoimmune condition initially triggered by strep infections, which disrupts a child’s normal neurologic activity.
PANS is an acronym for Pediatric Acute-onset Neuropsychiatric Syndrome, which is associated with a variety of different infections.


The majority of children who have PANDAS recover completely with treatment, although it may take time. Once the strep infection clears, symptoms usually start to get better slowly over several months although there may be ups and downs. However, if the child gets strep again, PANDAS is most likely to return.

Children with PANDAS and PANS are often Misdiagnosed
Obtaining a correct diagnosis can be a challenge because PANDAS and PANS symptoms can mimic other illnesses. Children with PANDAS and PANS are often misdiagnosed as having a psychiatric illness and are therefore treated solely with psychotropic drugs. Unfortunately, for PANDAS and PANS patients this does not treat the cause of their symptoms: an infection-triggered autoimmune condition.
Research has proven that when given the correct anti-infective and/or immunological treatment, PANDAS and PANS patients experience symptom resolution or drastic reduction. Obtaining a correct diagnosis can be a challenge since PANDAS and PANS symptoms can mimic other illnesses.

The symptoms of PANDAS and PANS

Although these conditions come from different sources, clinically they both present the same way. Healthy children experience rapid decline. Many of the PANDAS and PANS symptoms manifest over several days or even weeks. These symptoms can include the following:
• Obsessive-compulsive disorder (OCD)
• Motor tics
• Involuntary body movements
• Hyperactivity
• Urinary problems
• Aggression
• Suicidal thoughts
• Sleep disorders
• Eating disorders
• Sensory insensitivity or hypersensitivity
• Rapid decline of handwriting and math skills
• Hallucinations
• Mood swings

OCD Therapy is not enough when your child has OCD and PANDAS or PANS
PANDAS and PAN are not mental illness, yet many of their symptoms, such as OCD, can be alleviated through the proper therapy.
Treating PANS like typical OCD is a huge mistake. That is because PANS is not simply a sudden-onset OCD. PANS is an autoimmune condition that attacks the brain. This attack not only creates OCD, but it results in all sorts of other symptoms as described above. That is why it is not possible to fix the aforementioned problems by just treating PANS as if it is an ordinary case of OCD.

PANDAS and PANS treatment options

Treating either PANDAS or PANS can involve a three-pronged approach that utilizes antibiotic therapy to eliminate the neuroinflammation source, anti-inflammatory and immune-modulating therapies to treat immune system disturbances of the immune system; and when appropriate, psychiatric medications to provide relief from symptoms.
• Remove Inflammatory Source: antibiotic therapy.
• Treat Immune System Dysregulation: immunomodulating and/or anti-inflammatory and/or medications.
• Treat Symptoms: psychoactive medications, psychoactive therapies, and supportive therapies.

It usually takes a week or two for antibiotic therapy to be effective, although some children improve within days. The longer the symptoms have been active before the child starts treatment, the longer the response can take. Some children do not respond to the antibiotic treatment alone. Your doctor may have to try more than one antibiotic to discover what works. Many children can have episodes later, if triggered by another infection.

Strict dieting can help reduce inflammation and promote antibodies
Gluten can be inflammatory. That is why a child with either PANDAS or PANS should be placed on a gluten-free diet. Some children with these disorders have shown sensitivities to different types of foods: gluten, dairy, yeast and sugar.
That is why it is very important that these children adhere to strict diets. Why? Because when the child is overloaded with stressors, which include food, their symptoms increase. A strict diet eliminating foods that can result in more antibodies means that the child is eating better.
What should you do if you think your child has PANDAS/PANS?

First, make an appointment with you pediatrician or family doctor. Keep a written record of your child’s symptoms. Since some physicians are not familiar with PANDAS/PANS you should print out some information and bring it with you to the doctor appointment. You may also decide to find a mental health professional who can offer Cognitive Behavior Therapy for OCD, depending upon the severity and upon the type of symptoms.


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