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What is PANDAS?
Note: This is not medical advice and is for informational purposes only. If you need medical advice, contact a medical professional.
If you are a parent, you need to know about PANDAS. You may think it is the name of a group of animals you can see at the zoo. However, it is an acronym for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections.
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PANDAS is a behavioral disorder a child may suffer from suddenly after a strep throat infection. Although he or she may not develop PANDAS after contracting strep throat, it is important to be aware of the possibility. The onset of PANDAS is sudden.
When a child develops PANDAS, his or her behavior may change drastically. The behavior change is often severe, but temporary. The length and severity of the symptoms may vary, but they always present as obsessive or compulsive behaviors.
If a child develops PANDAS, getting him or her treated quickly is essential. Below is more detailed information about what PANDAS is, how to recognize it and how to treat it.
What PANDAS Is and How It Starts
PANDAS is a neuropsychiatric disorder, meaning it changes the way a child thinks or alters his or her moods. Its impact causes early and often temporary but severe symptoms of Obsessive-Compulsive Disorder (OCD). If a child has PANDAS, he or she may suddenly develop irrational worries or obsessions.
The full impact of PANDAS is still unknown. It is a relatively newly established disorder with new studies conducted on its effects often. However, its cause is known. It originates from the body of a child , but only under specific circumstances.
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The process begins with the strep bacteria. It can live in a child ‘s body for an extended period. It mimics other cells to avoid detection by his or her immune system. However, when it is finally detected, his or her immune system attempts to kill it.
In the process of trying to kill the strep bacteria, a child ‘s immune system may also attempt to damage or kill similar cells. When the bacteria mimic certain brain cells, it puts them at risk for damage. Therefore, the child may develop a normal case of strep throat and ward it off successfully. Then, if the wrong cells are involved, he or she may develop PANDAS soon after.
Common PANDAS Symptoms
The PANDAS symptoms a child experiences may present similarly to standard OCD symptoms. For example, he or she may have facial tics. His or her obsession with small details may also increase.
However, PANDAS is not the same as standard OCD. One variation is that a child may show symptoms of PANDAS when he or she is as young as three years of age. Those symptoms are likely to subside when he or she reaches puberty or soon after the onset of puberty. Specific symptoms potentially indicating PANDAS include the following:
- Hyperactivity or other ADHD-like symptoms, such as inability to focus
- Rapid changes in his or her moods
- Sudden severe separation anxiety, including obsessiveness about being in the same room with you
- Joint pain
- Difficulty controlling motor skills
- Jerky or unusual movements or tics
A child must be exposed to the strep bacteria to develop PANDAS. Exposure can occur because of contracting scarlet fever, strep throat or other ailments involving the strep bacteria. However, PANDAS is most commonly associated with strep throat.
Additionally, he or she can have strep throat more than once throughout his or her childhood. Therefore, another indication of PANDAS is the onset of severe symptoms in conjunction with multiple cases of strep throat.
How PANDAS Is Diagnosed
Diagnosing PANDAS can be difficult because its symptoms can resemble those of other disorders. Also, PANDAS is rare, so not all doctors are familiar with it. The PANDAS Physicians Network is one of several resources you can use to locate a physician capable of diagnosing PANDAS.
There are no laboratory tests used to determine if a child has PANDAS. However, there are laboratory tests to detect the presence of strep bacteria. A chosen specialist may begin by requesting a child ‘s history of strep throat or scarlet fever incidents.
He or she must determine if the onset of compulsive behaviors coincides with those incidents using clinical diagnostic criteria. For example, after the child’s medical history is taken and a strep test performed, his or her behaviors must be closely observed by the physician. Obvious signs of OCD, such as facial tics, can indicate PANDAS, but only if the symptoms are acute and linked to the strep bacteria.
If the child has no diagnosis of an illness involving the strep bacteria yet, he or she may still have PANDAS. The bacteria can hide in his or her body without producing symptoms. They are detectable using a blood test. The test must be performed at least a week after the OCD symptoms first occur to produce accurate results.
How PANDAS Is Treated
Children with PANDAS are likely to experience their worst PANDAS symptoms during and immediately following a streptococcal bacterial infection. When he or she has such an infection, it may present as strep throat. PANDAS will not appear from other conditions such as being at nutritional risk.
However, it can also present in other forms. Among those forms are:
- Scarlet Fever.
- Anal bacterial infection.
- Urethral bacterial infection.
- Vaginal bacterial infection.
- Sinus infection.
When a child has PANDAS, his or her physician can treat the underlying bacterial infection with antibiotics. Eradication of the infection lessens the severity of PANDAS symptoms quickly. However, he or she may still display some symptoms for several weeks or months after treatment.
The length of the antibiotic treatment may vary. For example, if a child has strep bacteria in his or her sinuses, it may take much longer to successfully treat than if he or she has a more common condition like strep throat.
Successful treatment of the bacteria responsible for PANDAS requires you to limit the odds of a child becoming reinfected with strep. To do so, everyone in your household must be tested for the bacteria. You must also replace any objects potentially harboring the bacteria, such as toothbrushes.
Treatment of the PANDAS symptoms themselves may require a child to temporarily take antidepressants or other medications in addition to the antibiotics needed to treat the strep bacteria. He or she may also need to undergo temporary behavioral therapy.
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