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PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcus infection) can develop after a common strep throat infection in kids and adolescents.
PANDAS is a controversial disorder that some physicians claim needs the medical community’s immediate attention.
The threat comes from bacterial infections that become systemic and reach the central nervous system. What begins with a strep infection transitions into OCD (obsessive compulsive disorder) or neurological tics.
The OCD-like behavior may come and go. This can carry on for months to years if left untreated. There may also be recurrent strep throat infections.
It may be a matter of months before neurological symptoms develop after a strep infection.
PANDAS caused by strep throat can be difficult to diagnose in a child. Once a streptococcus bacterial infection becomes systemic and reaches the central nervous system, it can cause OCD and neurological tics.
Other symptoms of PANDAS include:
Sometimes a child with PANDAS is mistakenly put on medication for OCD, behavioral disorders, or Tourette’s syndrome. The infection is missed. A child can suffer for well over a decade before a diagnosis of PANDAS is made.
While PANDAS affects mostly children, adults can also be diagnosed with the disorder.
PANDAS is a clinical diagnosis, which means that physicians must rely on two things: history and a physical exam. Because there are no lab tests that can diagnose PANDAS, this only contributes to the controversy that surrounds it.
When it comes to distinguishing the difference between strep throat and other bacterial or viral infections, swabbing the throat and getting a sample is the gold standard.
The specific strep bug that physicians are on the lookout for is called Group A beta-hemolytic streptococcus.
Unfortunately, this test is not always reliable. According to the National Institute of Mental Health, incorrect swabbing and false negatives are common and happen in at least 15% of children with strep throat.
A physician may also look for something called anti-streptococcal titers, which shows that the immune system is responding to a strep infection.
This requires two separate blood tests done several weeks apart. The timing needs to be just right in order to show a “rising titer.” If titers are merely high—and not actively increasing—this could be leftover from a previous strep infection since titers can stay high for several months.
Because physicians are still arguing over the causes and definition of PANDAS or know too little about it, this can leave parents and their affected children with little hope.
Simply getting a diagnosis is the first step.
While PANDAS looks like a behavioral disorder, it is caused by an infection. This means that it can be treated (usually with antibiotics) and that it will eventually resolve.
The strep bacteria can hide out in places other than the throat. For example, an occult (or hidden) strep infection may be found in the sinuses, the vagina, or where urine leaves the body. This means that even if a throat swab is negative, your child may still be affected by PANDAS.
One or several courses of antibiotics may be necessary in order to reduce and resolve the behavioral symptoms of PANDAS.
The problem with antibiotics is twofold.
When addressing PANDAS and strep infection, consider additional therapies that may reduce the use of antibiotics:
If you suspect that a child, teen, or young adult in your life has PANDAS, it is essential to act quickly and address the infection.
PANDAS, otherwise known as pediatric autoimmune neuropsychiatric disorders associated with streptococcus infection, is a controversial disorder that starts when a bacterial infection becomes systemic and affects the central nervous system. A strep infection can quickly turn into OCD or neurological tics. Other common PANDAS symptoms may include panic attacks, mood swings, ADHD, and frequent urination.
PANDAS is difficult to diagnose and may be missed altogether. A child may be medicated for behavioral disorders, OCD, or even Tourette’s syndrome. Getting a diagnosis for this condition is the first step to restoring you or your child’s health.
Since PANDAS is caused by an infection, it is normally treated with antibiotics in one or several courses. Unfortunately, antibiotics destroy the inner ecology of the gut, which can affect mental health.
To protect gut health, additional therapies can be used to treat PANDAS and strep, like:
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