Did you know that 1 in 200 children in the United States alone are affected by PANDAS, a complex disorder that can lead to sudden and severe changes in a child’s behavior, emotions, and physical health? As a parent, it’s essential to understand what PANDAS is and how it can impact your child’s well-being.
PANDAS, which stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a condition that occurs when a child’s immune system mistakenly attacks healthy brain cells following a strep infection. This autoimmune response can result in a wide range of neuropsychiatric traits, including Obsessive-Compulsive Disorder (OCD), tics, anxiety, and emotional lability.
Navigating the complexities of PANDAS can be overwhelming for parents, especially when faced with conflicting information and limited care options. We understand the challenges that families face when dealing with PANDAS, and we’re here to provide you with the knowledge, support, and drug-free care your child needs to thrive.
In this article, we’ll explore PANDAS, its signs, underlying causes, and the unique approach it takes to address the root of the problem.
What is PANDAS?
PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a condition that affects children, typically between the ages of 3 and 12. It is characterized by the acute onset of OCD or tic conditions, along with other neuropsychiatric traits, following a streptococcal infection, such as strep throat or scarlet fever.
Experts agree that the precise incidence and prevalence of PANDAS/PANS syndrome is unknown, but it is widely accepted that PANDAS is more common than is currently understood and recognized within the conventional medical system.
In children with PANDAS, the body’s immune system mistakenly attacks healthy brain cells, particularly in the basal ganglia, a region of the brain responsible for motor control, behavior, and emotions. This autoimmune response is thought to be triggered by molecular mimicry, a process in which the antibodies produced to fight off the strep infection cross-react with the child’s own brain tissue.
The resulting inflammation and dysfunction in the brain lead to the sudden appearance or worsening the signs of neuropsychiatric syndromes. They can be accompanied by other physical and neurological manifestations, such as changes in handwriting, sensory sensitivities, and sleep disturbances.
It’s important to note that while PANDAS is associated with streptococcal infections, not all children who contract strep will develop the condition. Studies show a strong link between PANDAS and genetic or hereditary factors. While researchers have not identified a specific gene linked to PANDAS, immune deficiencies and mental health conditions are contributing factors.
Diving one layer deeper, an additional component not often discussed enough with PANDAS is that most often the child already had signs of neurological dysregulation and dysautonomia even prior to the strep infections and resulting inflammation. This is why many families report still staying stuck on the PANDAS rollercoaster even as they move to an anti-inflammatory and integrative medicine approach via diet changes, detoxes, and supplements – because while those are absolutely necessary and crucial steps in caring for PANDAS naturally, this functional medicine approach often fails to address the foundational nervous system dysregulation that was there in the first place, leaving the child more susceptible to this neuroimmune storm.
Signs of PANDAS
One of the most striking features of PANDAS is the abrupt onset of traits, which can appear seemingly overnight. Children with PANDAS may experience a dramatic change in their behavior, emotional state, and overall functioning. The traits can be broadly categorized into three main areas:
Obsessive-Compulsive Disorder (OCD) Signs
Children with PANDAS may suddenly develop obsessive thoughts and compulsive behaviors. Research indicates that PANDAS pediatric patients account for up to 25% of children diagnosed with OCD. Some examples include:
- Excessive hand washing or cleaning
- Preoccupation with germs or contamination
- Intense fear of illness or harm coming to themselves or loved ones
- Repetitive checking or counting behaviors
- Arranging objects in a specific order or pattern
These obsessive-compulsive traits can be severe and distressing, interfering with the child’s daily life and causing significant anxiety.
Tic Signs
PANDAS can also cause the sudden onset or worsening of tic conditions, which are characterized by involuntary, repetitive movements or vocalizations. These may include:
- Motor tics: Eye blinking, facial grimacing, shoulder shrugging, or jerking of the head or limbs
- Vocal tics: Throat clearing, grunting, sniffing, or repeating words or phrases (echolalia)
Tics associated with PANDAS can be complex and severe, causing significant distress and impairment in social and academic functioning.
Other Neuropsychiatric and Physical Signs
In addition to OCD and tic traits, children with PANDAS may experience a range of other neuropsychiatric and physical manifestations, such as:
- Separation anxiety or fear of being away from parents
- Emotional lability, irritability, or aggression
- Age-inappropriate behaviors or temper tantrums
- Deterioration in school performance or handwriting
- Sensory sensitivities, such as sensitivity to light, sound, or touch
- Developmental regression, such as baby talk or loss of previously acquired skills
- Sleep disturbances, including difficulty falling asleep or frequent nightmares
- Urinary frequency or bedwetting (Enuresis)
It’s essential for parents to be aware of these signs and to seek medical attention if they notice a sudden onset or worsening of any of these signs in their child. Early recognition and intervention are crucial in managing PANDAS and minimizing its impact on the child’s quality of life.
Causes of PANDAS
Understanding the underlying causes of PANDAS is crucial for parents seeking to support their child’s health and well-being. While the exact mechanisms behind the condition are still being researched, several key factors have been identified as contributing to the development of PANDAS.
Group A Streptococcal (GAS) Infections
PANDAS is believed to be triggered by a misdirected immune response to Group A Streptococcal (GAS) infections, such as strep throat or scarlet fever. When a child contracts a GAS infection, their immune system produces antibodies to fight off the bacteria. However, in some cases, these antibodies mistakenly attack healthy brain cells, particularly in the basal ganglia, leading to the neuropsychiatric signs associated with PANDAS.
This process, known as molecular mimicry, occurs when the antibodies cross-react with the child’s own brain tissue due to structural similarities between the strep bacteria and certain brain proteins. The resulting inflammation and dysfunction in the brain give rise to the pediatric acute onset of OCD, tics, and other neuropsychiatric signs.
The “Perfect Storm” Concept
While GAS infections are a necessary trigger for PANDAS, not all children who contract strep will develop the condition. At PX Docs, we believe that a combination of factors, often referred to as the “Perfect Storm,” may contribute to the development of PANDAS in some children.
These factors include:
- Genetic vulnerability: Some children may have a genetic predisposition to autoimmune disorders or a heightened sensitivity to strep infections, increasing their risk of developing PANDAS.
- Environmental factors: Exposure to various environmental triggers, such as stress, toxins, overuse of antibiotics, birth trauma, or other infections, may exacerbate the immune response and contribute to the onset of PANDAS.
- Timing of infections: The age at which a child contracts a GAS infection and the frequency of infections may also play a role in the development of PANDAS.
The Role of Subluxation and Dysautonomia
In addition to the autoimmune response triggered by GAS infections, subluxation and dysautonomia may also contribute to the development and severity of PANDAS traits. Subluxation can lead to neurological dysfunction and altered communication between the brain and the body. Dysautonomia, an imbalance in the Autonomic Nervous System (ANS), can further exacerbate the neuropsychiatric traits associated with PANDAS.
Addressing subluxation and dysautonomia through targeted interventions, such as Neurologically-Focused Chiropractic Care, may help to restore proper nervous system function and support the child’s overall health and well-being in the context of PANDAS.
Diagnosis of PANDAS
Diagnosing PANDAS can be challenging, as the traits often mimic those of other neuropsychiatric syndromes. A comprehensive evaluation by a healthcare provider experienced in caring for PANDAS is essential for an accurate diagnosis. The diagnostic process typically involves a combination of clinical assessment, laboratory tests, and the exclusion of other potential causes.
Clinical Diagnostic Criteria
The diagnosis of PANDAS is based on the presence of the following clinical criteria:
- Pediatric acute onset of Obsessive-Compulsive Disorder (OCD) or tic signs
- Prepubertal age at onset (usually between 3 and 12 years old)
- Temporal association between acute onset and Group A Streptococcal (GAS) infection
- Presence of neurological abnormalities, such as motor hyperactivity or choreiform movements
Laboratory Tests
While there is no single definitive test for PANDAS, laboratory tests can help support the diagnosis and rule out other potential causes. These tests may include:
- Streptococcal antibody titers (ASO and Anti-DNase B): Elevated titers can indicate a recent GAS infection.
- Throat culture: A positive culture can confirm the presence of a current GAS infection.
Differential Diagnoses
Several other conditions can present with signs similar to PANDAS, making it important for healthcare providers to consider and rule out these differential diagnoses:
- PANS (Pediatric Acute-onset Neuropsychiatric Syndrome): A broader category that includes PANDAS and other infections or triggers.
- Tourette syndrome: A neurological condition characterized by chronic motor and vocal tics.
- Sydenham chorea: A neurological condition associated with rheumatic fever, which can cause involuntary movements and emotional disturbances.
At PX Docs we focus on root cause, natural, drug-free care solutions for children and families. This means that an in-depth diagnosis is not necessarily essential, since we do not treat or cure. However, when it comes to PANDAS especially it can be extremely helpful to have an accurate diagnosis so that both the parents and providers know what they’re up against and are not surprised by the sudden onset or clearing of symptoms, and the likely “rollercoaster” of recovery that is quite natural and normal with this complex condition.
Conventional Care Options for PANDAS
Conventional care for PANDAS typically involves a combination of medications and therapeutic interventions aimed at managing traits and addressing the underlying infection. While these care plans can be effective in some cases, they may not address the root cause of the condition and can have significant side effects.
- Antibiotics: PANDAS is triggered by a streptococcal infection, leading to antibiotic prescriptions to eliminate the bacteria and prevent future infections. In some cases, long-term prophylactic antibiotics may be recommended to prevent recurrent strep infections and PANDAS flare-ups. However, overuse of antibiotics raises the risk of antibiotic resistance, with studies showing that 25% of antibiotics prescribed to children were unnecessary.
- Cognitive Behavioral Therapy (CBT): Cognitive behavioral therapy is a form of psychotherapy that can help children with PANDAS manage their obsessive-compulsive signs and anxiety. This therapy focuses on identifying and modifying negative thought patterns and behaviors, providing children with coping strategies to better manage their traits.
- Immunomodulatory Therapies: In severe cases of PANDAS, immunomodulatory therapies may be considered to help regulate the immune system and reduce inflammation. Intravenous Immunoglobulin (IVIG) is an infusion of antibodies that can help modulate the immune response and decrease neuroinflammation. Plasmapheresis is a procedure that removes harmful antibodies from the blood, potentially alleviating the severity of PANDAS traits.
While these conventional and integrative treatment plans can provide relief for some children with PANDAS, they may not address the underlying neurological dysfunction and can have significant side effects. As a result, many parents are seeking other approaches that reach a deeper, more foundational layer of healing.
The PX Docs Approach to PANDAS: Unlocking Your Child’s Potential
We understand the challenges that families face when dealing with PANDAS, and we believe that every child deserves the opportunity to thrive. Our unique approach to PANDAS focuses on addressing the true root cause of the condition by supporting the child’s neurological health and function foundationally.
Central to our approach is the understanding that PANDAS is not just an autoimmune disorder, but a complex condition that involves neurological dysfunction and imbalance. By addressing subluxation, dysregulation, and dysautonomia through Neurologically-Focused Chiropractic Care, we aim to restore proper nervous system function and support the child’s natural healing processes.
To accurately identify areas of subluxation and nervous system dysregulation, PX Docs chiropractors utilize advanced neurological scans known as the INSiGHT scans. These scans provide a detailed assessment of the child’s neurological health, allowing our chiropractors to develop customized care plans that target the specific needs of each individual child.
By addressing subluxation and dysautonomia, our approach aims to restore balance to the nervous system, reduce the severity of PANDAS traits, and support the child’s overall development and quality of life. By taking a drug-free approach to PANDAS care, we aim to empower families with the knowledge and tools they need to support their child’s healing journey.
Empowering Families to Embrace Hope and Healing
We understand that navigating the complexities of PANDAS can be overwhelming for families. We are here to provide the support, guidance, and expertise you need to help your child unlock their full potential and thrive.
If you suspect that your child may be struggling with PANDAS, or if you have been searching for answers and solutions, we encourage you to visit the PX Docs Directory to find a qualified practitioner in your area. Our network of dedicated and compassionate chiropractors is committed to providing the highest quality of care and support for children with PANDAS and their families.
Remember, you are not alone in this journey. With the right care and support, your child can overcome the challenges of PANDAS and embrace a life of optimal health, happiness, and well-being. Take the first step today and discover the life-changing benefits of Neurologically-Focused Chiropractic Care for your child and your entire family.
