Navigating PANS/PANDAS; Is Your Child's Behavior Linked to Immune Dysfunction?

PANS/PANDAS - Could this be what my child is experiencing?

By Mary Margaret Burch, NP

In the wake of the Sars CoV2 pandemic, a heightened awareness and/or diagnosis of Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) along with PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) has emerged. These conditions are triggered by a misdirected immune response to one or more triggers, such as an infection, that lead to symptoms such as the following:

• Tics
• Obsessive compulsive thoughts or behaviors
• Anxiety (includes separation, social anxiety or irrational fears or panic attacks)
• Deterioration in school performance (such as handwriting, concentration)
• Enuresis or urinary frequency
• Aggression or oppositional behaviors 
• Food restrictions or new onset abnormal eating patterns
• Insomnia or sleep disturbances
• Occasionally, one may experience auditory or visual hallucinations with or without suicidal ideations

Overall, these types of symptoms or behaviors can be quite alarming for a family and lead to misdiagnoses of mental disorders without investigating into the possible root causes that are contributing to what may appear as solely a psychiatric or behavioral condition.

There are multiple testing modalities that can help guide a clinical diagnosis of PANS/PANDAS. At Real Health Medical, we seek to not only identify potential triggers to this condition, but also to decrease inflammation and correct underlying immune imbalances. This testing may include basic blood laboratory testing through LabCorp or Quest, comprehensive stool testing to evaluate the microbiome, assessing food allergies or sensitivities and mitochondrial function. Treatment plans may include homeopathy, Nambudripad Allergy Elimination Techniques (NAET), supplements that target the immune system and help to resolve inflammation, pharmacologic therapies such as medication. Other treatments that may be needed included plasma exchange, IVIG, antibiotics or anti-inflammatories. At Real Health Medical we also partner with other providers to help alleviate and repair overall emotion dysregulation and sensory processing difficulties that difficulties that may be contributing.  

As you can see, we take a whole person, integrative approach! There is hope for children and adults that are affected by PANS and/or PANDAS. Addressing the underlying physiological and environmental reasons that contributed to this condition can lead to healing!  

A 16-year-old girl who had a childhood history of repeated strep infections; she seemingly was able to bounce back and excel at school while maintaining good relationships with friends and family. Once she entered puberty around 12 years old, things began to change. She would not bounce back from infections easily, but instead become very irritable, her academic performance would decline, and she would become highly anxious and obsessed on what others thought of her. The thoughts seemed to consume most of her daily life and started to affect her sleeping habits. She would be lucky to get 4-5 hours of restful sleep most days of the week. Her parents, nor friends ceased to recognize her and wondered if this behavior would pass or if there was a real problem. She began to isolate herself more from her friends and became paranoid to leave her home in fear of others. Her parents began to have her evaluated by multiple medical providers from her pediatrician to neurology along with counseling. 

All tests were seemingly “normal”, and she was referred to a psychiatrist. After starting several different psychiatric medications, she was able to tolerate “life” better, although she became increasingly depressed, began to gain weight and lost her previously happy and kind demeanor. She continued to get repeated infections with waxing and waning escalations in her behavior that ranged from intense anxiety, ruminating thoughts and paranoia. By the age of 15 years old, she had to be homeschooled due to an ability to maintain her schoolwork and manage her anxiety in a large setting. Her parents ran across the diagnosis of PANS/PANDAS and realized that this really fit their daughters’ progressive symptoms. They sought an integrative approach to help their daughter. 

The practitioner began to evaluate patients’ overall health from the gut microbiome to oxidative stress levels, blood labs to assess immune function and sources of inflammation. By taking a comprehensive approach, the practitioner was able to properly diagnose the patient with PANS/PANDAS. 

Utilizing a variety of services to including: 

• Targeted supplements
• Allergy desensitization
• Immune modulation 
• Nutrition & lifestyle changes 

These approaches allowed the young girl to make tremendous gains in her overall health and well- being. She was able to titrate off all her psychiatric medication and begin to re-establish relationships with her peers.If you suspect your child or someone you care about could be suffering from PANS/PANDAS, don’t hesitate to take that next step.

To schedule an appointment for your child, complete our Pediatric Intake at: https://realhealthmedical.com/intake-pediatric and our Intake Coordinator will reach out to you through email to schedule.