Symptoms, Causes, Diagnosis & Treatment Of PANDAS

When a child falls ill, it can be one of the most challenging situations to cope with as a parent. This is especially true if you are unsure what’s causing the illness. Thankfully, many childhood illnesses are mild and clear up in a relatively short period. They also tend to present with symptoms that aren’t too worrisome. 

Some infections that can be common in children, including strep throat and scarlet fever, are caused by streptococcus, a type of bacteria. Kids are generally more likely to develop strep throat than adults. After a child has recovered from strep throat, they usually return to their healthy selves. However, some children may develop conditions known as pediatric autoimmune neuropsychiatric disorders, or PANDAS. But what is PANDAS, and how does it affect children? Read on to learn more about the symptoms, causes, diagnosis and treatment of PANDAS.

What is PANDAS? 

PANDAS is a syndrome that develops following a streptococcal infection. The immune system is alerted to the threat when bacteria enter the body, beginning a chain reaction designed to fight off bacteria and return the body to full health. 

However, in some children, the immune system goes into overdrive. That overreaction causes the brain to experience an inflammatory response. The antibodies created by the immune system to fight off the infection end up attacking healthy brain tissue by mistake. 

What causes PANDAS disorder? 

The leading cause of PANDAS is a strep infection. Typically, following the illness, the syndrome can develop because of how the immune system responds. However, some new research has shed light on the fact that it isn’t only strep infections that can lead to PANDAS. Viral and other bacterial infections can also set off the chain of events that lead to this unusual syndrome. 

When the immune cells begin attacking healthy brain cells, it is considered an autoimmune condition. In the case of PANDAS, that attack on the brain affects how the central nervous system functions. And since the central nervous system is vital to the body’s overall function, it can lead to some severe symptoms. 

Image by Michal Bar Haim on Unsplash: How is PANDAS diagnosed? 

What are the symptoms of PANDAS? 

When symptoms begin to develop in a child with PANDAS, they do so quickly. The syndrome’s effects are immediate in children and affect both their mental and physical health. Symptoms may vary from child to child, and not all children will develop all symptoms associated with the syndrome. 

The symptoms that may arise in a child with PANDAS include: 

  • Traits that resemble obsessive-compulsive disorder
  • Motor and verbal tics or other unusual movements in the face or body 
  • Loss of motor skills
  • Sensitivity to light 
  • Issues with sleep 
  • Fatigue 
  • Hallucinations that can be both visual and auditory 
  • Moodiness or irritability that is out of character 
  • Aggressive behaviors that are out of character
  • Changes in personality 
  • Bedwetting 
  • Not eating 
  • New separation anxiety 
  • Pain in the joints 

Although not all of these rapidly developing symptoms will be present, children typically experience a combination. Further, if a child already suffers from various neurological symptoms before the infection, they may become worse or more pronounced. 

Is PANDAS a clinical diagnosis? 

It can be challenging to confirm a case of PANDAS because it involves a clinical diagnosis, meaning no tests such as scans or blood tests can initially be used to determine if a child has the syndrome. The pediatrician examining the child will have to make note of symptoms and health history to come to a diagnosis based on these alone. 

How is PANDAS diagnosed? 

There are a few guidelines that medical providers will need to adhere to in order to make a proper clinical diagnosis of PANDAS. For example, the child’s age will factor in significantly. Since the disorder typically develops in children between the ages of three and the onset of puberty, if a potential PANDAS patient falls into that category, the condition will be explored further. 

Doctors will also use the presence of an obsessive-compulsive disorder or tic disorder as another guideline, since these are often hallmark symptoms of PANDAS. New neurological issues that weren’t present before the onset of symptoms are also a good indicator of PANDAS in a clinical diagnosis. These neurological symptoms must also come on rapidly and worsen over time. 

One last aspect of diagnosing PANDAS involves a test to check for a previous strep infection. This type of test is typically only done if a child has had symptoms for at least a week and the medical provider is unsure whether the child had a previous strep infection. 

Image by the CDC on Unsplash: What causes PANDAS disorder? 

What is the treatment for PANDAS disease? 

Since a strep infection causes PANDAS, the first treatment step is providing antibiotics. Typically, after a throat culture is done to confirm infection, doctors can offer children one course of antibiotics, which will rid the body of the bacteria. Once the illness itself is gone, the symptoms of PANDAS should dissipate.  

In some instances of PANDAS, a throat culture for strep may come back negative. In this case, the medical provider will typically go through other testing to see if another infection is present. That will help them determine what pathogen or illness has caused the symptoms of PANDAS. The infection will then be treated to resolve symptoms. 

Can PANDAS come back after treatment? 

While the onset of PANDAS symptoms is rapid, its recovery is not. Children who undergo antibiotic treatment for strep and PANDAS symptoms will begin to see the symptoms go away slowly and gradually over time. In some cases, if a child gets another strep infection, PANDAS symptoms can recur. In that case, treatment with antibiotics will need to happen again. 

It can take anywhere from a few weeks to several months for all of the symptoms of PANDAS to go away entirely after a child has developed the syndrome. Each case will differ from child to child, but once treatment begins, symptoms typically subside without causing further damage. 

Featured image by Pavel Danilyuk on Pexels

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