For years physicians who treat children with autism and other DSM diagnosis have stated that there is a link between these conditions and PANDAS (Pediatric Autoimmune Neuropsychiatric Diagnosis Associated with Streptococcal Infections). The patients they treat with biomedical interventions have experienced improvements and up until recently, mainstream medicine was not on board. This all changed when the Director of the National Institute of Mental Health stated that PANDAS is indeed a real medical illness.
The NIMH states that PANDAS is used to describe a subset of children and adolescents who have Obsessive Compulsive Disorders and/or tic disorders whose conditions worsen following strep infections such as Strep throat and Scarlet Fever.
PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) is a newer term used to describe the larger class of acute-onset OCD cases and includes all cases of abrupt onset – not just those associated with strep infections. Lyme disease, staph infections, mycoplasma infections such as walking pneumonia and rheumatic fever have been linked with PANS.
PANDAS/PANDS leads to autoimmune-mediated inflammation of the brain and attacks parts of the brain known as the basal ganglia and the anterior cingulated gyrus resulting in serious changes in behavior, movement control, obsessive thoughts and extreme emotional ups and downs.
The following symptoms are usually seen in children diagnosed with PANDAS/PANS:
- Severe separation anxiety
- Generalized anxiety. which may progress to episodes of panic and a ‘terror-stricken look’
- Hyperactivity, abnormal movements, and a sense of restlessness
- Sensory abnormalities, including hyper-sensitivity to light or sounds, distortions of visual perceptions, and occasionally, visual or auditory hallucinations
- Concentration difficulties, and loss of academic abilities, particularly in math and visual-spatial areas
- Increased urinary frequency and a new onset of bed-wetting
- Irritability and emotional lability. Abrupt onset of depression can also occur, with thoughts about suicide.
- Developmental regression, including temper tantrums, "baby talk" and handwriting deterioration
How Does This Relate to Autism?
It is estimated that more than 30% of children with autism also have PANDAS/PANS. In children diagnosed with autism, the extreme pain from brain swelling may lead to head-banging behavior. Unfortunately, medical professionals view head-banging as stimming and are not likely to do the lab tests necessary to determine if the child’s brain is inflamed due to a severe bacterial infection. It is important to advocate for your child as many children on the spectrum make dramatic improvements with several documented cases of complete recovery once properly diagnosed and treated.
Testing for PANDAS/PANS
The diagnosis of PANDAS is a clinical diagnosis, which means that lab tests alone are not enough to qualify for the diagnosis. Instead clinicians use diagnostic criteria for the diagnosis of PANDAS that includes some lab work. Recommended lab work includes:
- Measuring anti-streptococcal antibody titers to determine whether there is immunologic evidence of a previous strep infection.
- Throat swab or 48-hour strep test
- Check family members to see if someone is a strep carrier. Carriers are often asymptomatic, but will test positive for strep.
Diagnostic Criteria for PANDAS/PAN are:
- Presence of obsessive-compulsive disorder and/or a tic disorder
- Pediatric onset of symptoms (age 3 years to puberty)
- Episodic course of symptom severity
- Association with group A Beta-hemolytic streptococcal infection (a positive throat culture for strep or history of Scarlet Fever)
- Association with neurological abnormalities (motoric hyperactivity, or adventitious movements, such as choreiform movements).
Treatment Options
Traditional treatment includes Cognitive Behavior Therapy, antibiotic treatment and immune based treatment such as IVIG or Prednisone.
At Healing 4 Soul, we recognize other treatment approaches that have been effective throughout the world. We are seeing success treating PANDAS/PANS using Pleo Sanum remedies and supplements. The Healing 4 Soul PANDAS/PANS treatment plan includes some, if not all, of following:
Scheduling an appointment with Sima Ash will allow her to look at the specifics of your child’s case and also utilize other modalities such as CEASE Therapy to provide further benefit. You can call our office at (800) 669-0358 to schedule an appointment in our office, over the phone or via Skype.