Your child seems to have changed overnight. Their fears, behaviors, and actions are similar to an obsessive-compulsive disorder, yet they are now wetting the bed, getting pickier about food, and struggling at school. What’s happening? Well, it could be PANDAS or PANS, two autoimmune disorders that create a sudden onset of OCD symptoms. But, despite contrary belief, PANDAS and PANS do not only occur in children. It also occurs in adults and seniors, and it’s more common than you might think. Therefore, let’s dive in to learn about its signs, symptoms, and treatment options to help you or a loved one receive the help they deserve.
What Are PANDAS and PANS?
Imagine a child doing well in school, at home, and with their peers. Then, almost overnight, they begin behaving like a different person. Their once sociable nature is now aggressive, depressed, or anxious. And behaviors like washing their hands repeatedly, forgetting how to complete their school work, and even bed-wetting are all out of character, but their new norm. Unfortunately, these situations are examples of how PANDAS and PANS may affect your child or loved one.
PANS (Pediatric acute-onset neuropsychiatric syndrome) and PANDAS (Pediatric acute-onset neuropsychiatric syndrome associated with streptococcus) are both autoimmune disorders that disrupt neurological functioning.
PANDAS and PANS are very similar, with a few key differences. For example, children with PANS experience a drastic onset of OCD symptoms, whereas PANDAS may take 2-3 days for symptoms to manifest. Another important difference is the cause. PANS can be triggered by various infections, whereas to receive a diagnosis of PANDAS, a child must test positive for a recent streptococcal infection.
However, both disorders cause severe neurological symptoms that create distress for both the children and the family dynamic. Let’s take a look at these symptoms to know what to look out for, and how they may impact your child.
19 Symptoms of PANDAS and PANS
The signs and symptoms vary from person to person, but happen suddenly. Indeed, some parents even report their children changing drastically overnight. Common signs and symptoms include;
- Tics and repetitive movements
- Mood swings
- New sleeping difficulties
- New bedtime fears
- Decreased school performance
- Changes in memory
- Dilated pupils
- Hallucinations (visual/auditorial)
- Uncontrollable crying or laughing
- New bed wetting or frequent urination
- Separation anxiety or clingier than usual
- Behavioral regression – baby talk, sucking on thumb
- Sensory sensitivities to light, touch, noise or clothes
- Sudden trouble with fine motor skills like handwriting
- Selective eating or new food preferences, new fears about food, eating/choking
2 Causes of PANDAS and PANS
Experts believe PANDAS and PANS occur after a problem with the immune system’s ability to fight off an infection.
- Several factors can cause a misdirected immune response in PANS including neurological issues, inflammatory reactions, and infections like chickenpox, the flu and Lyme disease to name a few.
- PANDAS is a subset of PANS and occurs in response to streptococcus pyogenes also known as group A strep (GAS). This type of bacteria attacks the nervous system causing symptoms to appear during or after an infection, but not all children who come into contact with this bacterium get PANDS.
If your child or loved one tests positive for PANDAS and PANS, a healthcare professional will create a three-step treatment plan. This plan includes treating symptoms, removing the inflammatory source, and treating the immune system problem.
7 PANDAS and PANS Treatment Options
1. Antibiotic therapy
Providing antibiotics is the first step to treating both disorders. The antibiotics treat the underlying infection and strengthen the immune system. However, while some children may dramatically improve almost as quickly as the symptoms began, some need additional therapies to treat lingering behavioral symptoms.
2. Cognitive behavior therapy
Once doctors target the inflammation source, they can begin treating the behavioral symptoms. For example, to manage the OCD symptoms such as tics, obsessions, and mood swings, many mental health professionals advise patients to undergo cognitive behavior therapy. This therapy also helps family members and loved ones learn coping skills to deal with the sudden onset of symptoms and any future concerns.
3. Mood stabilizers
Many doctors with experience treating PANDAS and PANS don’t typically prescribe medication. However, if the disorder persists for a long time, they may prescribe a low dose of SSRIs (Selective serotonin reuptake inhibitors) to treat the OCD and anxiety symptoms.
IVIG (intravenous immunoglobin) involves treating the immune system dysregulation. It helps with several autoimmune illnesses, and with PANDAS specifically, it reduced the OCD symptoms by 82% in a small sample. While effective, IVIG is only recommended for severe or long-term cases. It is quite expensive, usually not covered by insurance, and can be emotionally taxing on the child.
Steroids, particularly corticosteroids, can be beneficial for children who experience an abrupt onset of symptoms. However, like mood stabilizers, it may not be recommended for young children due to possible side effects, including aggression and mania. But despite these risks, studies found it works well short-term with PANS and other autoimmune disorders.
6. Special diet
Other treatment options include placing a child on a strict gluten-free diet. Research shows gluten can be inflammatory, and reducing or eliminating it entirely may promote antibodies, strengthen the immune system, and reduce inflammation of the infection.
7. Early detection
The process of detecting PANS can be a frustrating and lengthy process. For example, many doctors don’t have experience with PANDAS and PANS and may misdiagnose the OCD symptoms as a psychiatric disorder. To ensure your child receives early detection and treatment, you should record their symptoms and notice if their behaviors change suddenly. For example, keep a watchful eye out for any changes in their school work, personality, fears, and daily interactions. If so, it’s worth looking into whether PANDAS and PANS may be the reason.
Above all, if your child has PANDAS and PANS, it may feel like a nightmare. Symptoms occur almost overnight, and the road to recovery can be challenging. But treatment is available, it is not a lifelong condition, and there is hope for your family and loved ones.
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