PANDAS is the acronym for the health condition known as “pediatric autoimmune neuropsychiatric disorders associated with streptococcus”. It is a syndrome that can occur after a child contracts an infection caused by the Streptococcus pyogenes bacteria.
Strep infections are typically mild and present with a sore throat or skin infection; however, they can sometimes be severe. When they are more serious, they can cause strep throat, scarlet fever and other types of illnesses. The strep bacteria is spread when someone with an infection coughs or sneezes, sending infected droplets into the air and onto surfaces. If a child breathes in those droplets or touches an infected surface and then their face, they could get the infection.
Although many people with strep infections experience only mild or moderate illness and completely recover, some children with the infection will develop other symptoms that affect them physically and psychologically. That is where PANDAS comes in. The symptoms associated with this condition will appear a few weeks after the initial infection. But the main issue with PANDAS is that once symptoms do develop, they tend to rapidly worsen.
What are the signs of PANDAS?
There are many different signs and symptoms associated with PANDAS, some of which affect the body and some that affect the mind. The onset of symptoms is sudden and can become so severe that it interferes with the child’s day-to-day life. Symptoms tend to worsen just as quickly and peak two to three days after they’ve started.
The psychological symptoms and signs of PANDAS can include:
- Obsessive, compulsive, and repetitive behaviors (much like OCD)
- Panic attacks, unwarranted fear, and a new separation anxiety
- Irritability, moods that change frequently, and incessant screaming
- Emotional or developmental regression
- Hallucinations that can be both visual and auditory
- Depression accompanied by suicidal thoughts
These symptoms can occur in conjunction with other physical symptoms such as:
- Unusual movements or new tics
- New sensitivity to light, sound, or touch
- Deterioration of small motor skills
- Poor handwriting
- Hyperactivity and the inability to focus
- Problems with memory
- Inability to sleep
- Refusing to eat meals
- Weight loss
- Joint pain
- Bedwetting or frequent urination
- Catatonia
In most cases, children with PANDAS will present with just some of these signs and symptoms, but they will always experience both psychological and physical ailments.
Is there as test for PANDAS?
The cause of PANDAS isn’t well known, and research continues to hunt for an answer as to why some children develop the condition while others do not. Theories exist, though, and one suggests that a faulty immune system may be to blame. The bacteria that causes PANDAS has a way of evading the immune system, and in doing so, causing the antibodies that were created to fight it off to start attacking the body’s own tissues.
Because the cause of PANDAS isn’t clear, diagnosis can be difficult. Your child’s doctor will likely test for the strep bacteria by doing a throat culture or a blood test. There are no specific tests designed specifically for PANDAS, so finding out if your child has a strep infection could help identify the condition.
What to do if you suspect your child has PANDAS
If you suspect that your child has PANDAS, the best thing you can do is get them to the doctor immediately, as it’s important to make sure that this condition is diagnosed and treated properly. It can also be helpful to record the child’s behavior and symptoms in a journal that you can bring with you to your visit. This will help the doctor get a proper read on all the symptoms your child is exhibiting.
The strep infection will first be treated by antibiotics, and the other symptoms will have to addressed separately. Psychological symptoms may be treated using cognitive behavioral therapy or serotonin reuptake inhibitors. In some cases, controversial treatments such as corticosteroids may be used, but these are generally only prescribed on a case-by-case basis.
Severe cases of PANDAS are often unresponsive to treatment. If that occurs, a blood plasma exchange will need to be done to remove antibodies that are attacking the body’s own tissues from the blood. Because there are various forms of treatment and severities of PANDAS, getting your child to their doctor as soon as you notice any signs is the best thing to do for their health.
Can PANDAS be mistaken for autism?
The wide range of symptoms involved and the way PANDAS affects cognition can make it hard to diagnose and easy to confuse with other conditions. Some cases of PANDAS have been misdiagnosed as obsessive-compulsive disorder, autism, Tourette’s syndrome, anorexia, and other types of psychiatric disorders. The fact that many children only exhibit some of the signs of PANDAS also contributes to misdiagnosis.
Although PANDAS can be mild or severe, it’s vital that you are aware of the signs so that if your child does develop the condition, you can have it treated effectively and quickly.
Featured image by Vitolda Klein on Unsplash
