As a parent, it is natural to be concerned about your child’s health, especially when it comes to their mental well-being. If you have heard of terms like PANDAS, PANS, or POTS and are worried that your child may be affected, this blog post aims to provide you with essential information and guidance. While these conditions can be complex and sometimes controversial, it is crucial to be informed and proactive in seeking appropriate care for your child.
Understanding PANDAS and PANS
PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) are terms used to describe a subset of children and adolescents who experience sudden-onset obsessive-compulsive disorder (OCD) and/or tic disorders.
PANDAS/PANS is a term used to describe a set of pediatric disorders characterized by sudden-onset neuropsychiatric symptoms. It is believed to be triggered by infections, particularly streptococcal infections. The immune response to the infection leads to an autoimmune reaction that affects the brain, resulting in various neuropsychiatric symptoms.
Symptom Presentation and Diagnosis
Abrupt onset or exacerbation of obsessive-compulsive disorder (OCD) symptoms.
Rapid onset or worsening of tics or tic-like movements.
Sudden development of anxiety, including separation anxiety.
Emotional and behavioral changes, such as irritability, mood swings, and aggression.
Development of restrictive eating patterns or food restrictions.
Impairment in school performance or decline in cognitive abilities.
Sleep disturbances, including insomnia or bedwetting.
Gender Differences in PANDAS and PANS
While research on gender differences in PANDAS is limited, some evidence suggests a potential disparity. Boys may be more likely to develop tics, while girls may be more prone to OCD-like behaviors. However, further investigation is needed to fully understand these distinctions.
Potential Causes of PANDAS and PANS
The exact cause of PANDAS is not yet fully understood. Researchers believe that a hyperactive immune response to streptococcus bacteria may contribute to the development of these disorders. Streptococcus bacteria commonly cause strep throat infections, which are prevalent among children.
Treatment for PANDAS and PANS
Treating PANDAS and PANS involves addressing the underlying strep infection. In many cases, a single course of antibiotics can effectively treat the infection. More severe cases may require a longer course of treatment or multiple rounds of antibiotics. It is important to note that PANDAS symptoms usually fade once the underlying infection is treated. However, progress may be gradual, and additional interventions can help manage symptoms in the interim.
Antibiotic therapy: In cases where streptococcal infections are present or suspected, appropriate antibiotic treatment may be prescribed to target and eliminate the bacteria.
Anti-inflammatory measures: Since PANDAS/PANS involves an immune response and inflammation, reducing inflammation in the body may be beneficial. This can be achieved through dietary changes, such as an anti-inflammatory diet, and the use of supplements that have anti-inflammatory properties, such as omega-3 fatty acids.
Immune modulation: Balancing the immune system and reducing autoimmunity may be targeted through various approaches, including the use of specific supplements, probiotics, and addressing any potential underlying immune dysfunctions.
Nutritional support: Optimizing nutrition and addressing any nutrient deficiencies can be an important part of the treatment plan. This may involve working with a qualified healthcare practitioner to develop an individualized dietary and supplementation protocol.
Behavioral and psychological interventions: Addressing the neuropsychiatric symptoms often requires the involvement of mental health professionals. Cognitive-behavioral therapy (CBT) and other psychotherapeutic approaches can be employed to help manage symptoms and improve overall well-being.
It’s important to note that the specific treatment plan for PANDAS/PANS should be developed in consultation with a healthcare professional experienced in integrative functional medicine, who can consider the individual’s unique circumstances and provide personalized recommendations.
Ongoing Research and Controversy
It is important to note that PANDAS is not formally listed in the DSM-5, the diagnostic manual used by mental health professionals. It falls under the category of “Obsessive-Compulsive and Related Disorder Due to Another Medical Condition.” While evidence supports the existence of PANDAS, its diagnosis remains controversial and subject to further study.
PANS and POTS
It is worth mentioning another related condition called POTS (Postural Orthostatic Tachycardia Syndrome). POTS is a condition that involves an abnormal increase in heart rate upon standing, often accompanied by dizziness, lightheadedness, and other symptoms.
Although POTS is not directly linked to PANDAS or PANS, it is important to be aware of its existence, as some children with PANDAS or PANS may also experience POTS symptoms.
As a concerned parent, it is understandable that you may have questions and worries about your child’s health, particularly when it comes to conditions like PANDAS, PANS, and POTS. While these disorders may still be the subject of ongoing research and clinical debate, it is essential to stay informed and seek appropriate professional guidance for your child.
Remember, if you suspect that your child may be affected by PANDAS, PANS, or POTS, consult with a healthcare professional who is knowledgeable about these conditions. They can provide a comprehensive evaluation, including a thorough medical history review, physical examination, and any necessary diagnostic tests to determine the best course of action.
Treatment for PANDAS and PANS focuses on addressing the underlying strep infection with antibiotics. Additionally, short-term therapy, such as CBT or ERP, can help your child manage their symptoms while the infection resolves. With the right treatment and support, many children with PANDAS and PANS experience improvements in their symptoms over time.
Several Philadelphia Integrative Psychiatry Providers are trained to specifically treat PANDAS/PANS. Contact us for a consultation.