PANDAS: A Guide for Children

What is PANDAS?

PANDAS means pediatric autoimmune neuropsychiatric disorders associated with streptococcus. The syndrome involves abrupt and frequently major shifts in personality, behavior, and movement in children following an infection involving Streptococcus pyogenes (streptococcal-A infection).

Strep infections can be mild, causing just a minor skin infection or sore throat. On the other hand, they can cause acute strep throat, scarlet fever, and other disorders. Strep is found within the throat and on the surface of the skin. You contract it if an infected person coughs or sneezes and you also breathe in the droplets or touch contaminated surfaces, and then touch your face.

Most people with a parasite disease create a complete recovery. However, some kids develop sudden physical and psychiatric symptoms a couple of weeks after disease. Once they start, these symptoms have a tendency to rapidly becoming worse.
Carry on reading to learn more about the symptoms of PANDAS, how it’s treated, and where you can turn for support.

What are the Signs?

The observable symptoms of PANDAS start suddenly, approximately 4 to 6 weeks after a sinus infection. They include behaviors similar to obsessive-compulsive disorder (OCD) and Tourette syndrome). These indicators can restrict schooling and also immediately become debilitating. Symptoms interrupt and reach their peak usually within 2 to three days, contrary to other youth psychiatric illnesses that develop more gradually.

Emotional symptoms might include:

  • obsessive, compulsive, and repetitive behaviors
  • Separation anxiety, anxiety, and fear attacks
  • Incessant crying, irritability, and frequent mood effects
  • Emotional and developmental regression
  • Visual or auditory hallucinations

Physical disorders can include:

  • Tics and unusual movements
  • Rust of small motor skills or poor handwriting
  • Hyperactivity or an inability to focus
  • Memory Issues
  • Trouble sleeping
  • Refusing to eat, that May Lead to weight loss
  • Joint pain
  • Frequent urination and Bed-wetting

Kids with PANDAS do not necessarily have all of these symptoms, however, they often have a variety of several physical and psychiatric symptoms.

What causes it?

The precise reason behind PANDAS could be the subject of continuing research.

One theory suggests that it may be due to a faulty immune response to a strep infection. Strep bacteria are especially good at hiding from the immune system. They conceal themselves together with molecules that look similar to ordinary molecules found in your system.

The immunity system catches to the strep bacteria and begins producing antibodies. However, the disguise continues to confuse the antibodies. Consequently, the cells attack the body’s own tissues. Antibodies targeting a given area of the brain, the basal ganglia, can trigger the neuropsychiatric symptoms of PANDAS.

Precisely the identical set of symptoms might be brought on by ailments which do not involve bacteria that are parasitic.

Who is at risk?

PANDAS is most likely to grow children between 3 and 12 years old who have had a strep disease within the last four to six weeks.

Some other potential risk factors include genetic predisposition and recurrent infections.

Your child is more likely to have yourself a strep disease in late fall and early spring, especially once they’re in close quarters with large collections of individuals. To help prevent strep infection, teach your child not to share eating utensils or drinking glasses, also to clean their hands regularly. They must avoid touching their eyes and face whenever you can.

How can it be recognized?

In case your child is showing unusual symptoms after infection of any type, make an appointment with your pediatrician right away. It may be useful to keep a journal detailing these symptoms, including if they started and how they are impacting your child’s life. Bring this advice, together with a list of any prescription or over-the-counter medications your child takes or has lately taken, once you visit your doctor. Make sure you report any diseases or disorders that have been available at school or at home.

To diagnose a parasite disease, your pediatrician may consider a throat culture or run a blood test. But, there are no lab or neurological evaluations to diagnose PANDAS. Instead, your physician might need to perform many different urine and blood tests to rule out some other childhood ailments.

A diagnosis of PANDAS requires a careful medical history and physical examination. The criteria for diagnosis are:

  • Being between 3 Years old and puberty
  • Sudden onset or worsening of already existing signs, together with symptoms becoming more acute for periods of time
  • Presence of Obsessive Compulsive behaviors, tick disease, or equally
  • Signs of other neuropsychiatric symptoms, such as anxiety, mood changes, developmental regression, or anxiety
  • Previous or present strep-A disease, supported by a throat culture or blood test

What is the treatment?

Fixing PANDAS involves addressing both psychiatric and physical symptoms. To begin, your physician will concentrate on making certain the strep infection is completely gone. You can also assist a licensed mental health professional knowledgeable about OCD and PANDAS.

Treating the strep infection

Most strep infections are successfully treated with a single course of antibiotics.

  • amoxicillin
  • azithromycin
  • cephalosporin
  • penicillin

You should also consider having other family members tested for strep because it is possible to carry the bacteria though you have no signs. To help avoid re-infection, change out your child’s toothbrush right away and when they finish their whole course of antibiotics.

Fixing psychological symptoms

Psychiatric symptoms may start to improve using antibiotics, but they’ll likely still want to be dealt with separately. OCD along with other psychiatric symptoms are generally treated with cognitive behavioral therapy.

OCD additionally usually responds well to selective serotonin reuptake inhibitors, a kind of antidepressant.

  • fluoxetine
  • fluvoxamine
  • sertraline
  • paroxetine

These medications will be prescribed in tiny doses to get started. They can be slowly increased if necessary.

Other treatments are contentious and have to be determined by a case by case basis. Yet, steroids can make tics a whole lot worse. Additionally, when steroids do work, they can only be used to get a short time. Now in time, steroids aren’t routinely recommended for the treatment of PANDAS.

Some severe situations of PANDAS may not answer therapy and medications. Should this happen, a blood flow exchange to eradicate the faulty antibodies from their bloodstream is occasionally recommended. This procedure uses healthy donor blood plasma products that will help boost your child’s immune system. When some clinicians report success with all these treatments, you will find no studies verifying that they work.

Are there some possible complications?

Outward indications of PANDAS may leave your child unable to operate at school or in social conditions. Untreated, outward symptoms of PANDAS might continue to worsen and could result in permanent cognitive damage. For several kids, PANDAS may become a chronic autoimmune condition.

Where can I get assist?

With a child with PANDAS can be particularly stressful because it tends to run on without warning. Over the course of a couple days, you might notice striking behavioral changes with no apparent reason. Increasing this challenge is the fact that there is no one test for PANDAS, through diagnostic criteria are developed. It’s important to be certain these criteria are met before assessing PANDAS.

In case you feel overwhelmed, consider these tools:

  • PANDAS Network delivers general information, news about the most recent research, and lists of doctors and service groups.
  • International OCD Foundation includes info about OCD in kids along with a downloadable fact sheet comparing OCD to PANDAS and PANS. This is particularly useful if your swimmer is not very familiar with PANDAS.
  • The PANDAS Physicians Network offers PANDAS Practitioner Directory, a searchable database of health practitioners that are familiar with PANDAS.

Your child might also need additional help at school. Talk for their teacher or school administrators in regards to the identification, what this means, and the way you can all work together from the best interests of your child.

What’s the outlook?

PANDAS was not identified until 1998, therefore there are no longterm studies of children with PANDAS. However, it will not mean your kid cannot get much better.

Some kids improve quickly after starting antibiotics, even though symptoms can go back if they receive a new strep illness. Most recover without significant long term outward symptoms. For many others, it may grow to be an ongoing problem requiring regular use of antibiotics to control infections that may cause flareups.


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