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PANS / PANDAS

What are PANS/PANDAS?

PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection and PANS stands for Pediatric Acute-onset Neuropsychiatric Syndrome. PANDAS and PANS usually occur in children; however, adults can also suffer from these syndromes. In individuals who suffer from PANDAS or PANS a streptococcal or other infection (respectively) will cross the blood brain barrier and inflame certain parts of the brain. This inflammation will often look like a rapid onset of OCD or other mental health disorder.

How do PANS/PANDAS make my or my child’s brain mimic a mental health condition?

These conditions cause the brain to function in some similar ways to how the brain would respond to experiencing some mental health conditions, including OCD. The process by which this occurs is called molecular mimicry. This is similar to how an autoimmune disease (e.g., Rheumatoid Arthritis or Lupus) functions in the body in that the immune system attacks brain tissues rather than protecting it. The area of the brain that is most impacted by a PANS or PANDAS condition is call the Basal Ganglia (primarily responsible for movement and behavior) (Moleculaera labs, 2018).

What are some indicators that my child may be suffering from PANS or PANDAS?

Most often when a child or adult suffers from OCD (not brought about by PANS/PANDAS) the onset (or time it takes to see the full presentation of the illness) is usually a slow and gradual process. Most children will start to experience symptoms in mid-childhood (pre-adolescence). According to a study by Swedo, Rapaport, Leonard, Lenane, and Cheslow (1989) the average age of onset for boys is 9.5 years and 11.0 years for girls. The onset of OCD tends to be slow where your child may start to display symptoms of experiencing intrusive thoughts and engaging rituals like repetitive checking, washing/decontaminating, counting, seeking reassurance repeatedly, etc.

In contrast, a PANS or PANDAS onset and symptom presentation can look quite different than the normal course of OCD symptom onset found in children. The course by which symptoms start to appear in a child who suffers from PANS/PANDAS tends to be much more rapid. Symptoms can appear overnight or within a short period of time often following an illness like a Streptococcal infection. Children with PANS/PANDAS also tend to show more signs of acting out behaviorally including tantrums, oppositional behavior, and unpredictability. This may be the case with an OCD diagnosis that is not associated with PANS/PANDAS; however, it is more often the case with the rapid onset presentation. OCD (not brought about by PANS/PANDAS) also tends to impact other areas of the brain (e.g., anterior cingulate, orbital frontal cortex, and caudate nucleus) whereas PANS/PANDAS primarily impacts the basal ganglia.

What can I do as a parent or guardian to help my child?

Portland Anxiety Clinic works with children, adolescents, and adults as well as their families who suffer from PANS/PANDAS. The behavioral health treatment does not differ from what is done with individuals who suffer from OCD; however, your physician may prescribe different medications than what may normally be prescribed for OCD or other related conditions. PANDAS and PANS can both be treated at the outpatient, IOP, and PHP levels of care at Portland Anxiety Clinic.

What if I have additional questions?

We are happy to answer any additional questions you may have about PANS/PANDAS or any other condition that we treat at Portland Anxiety Clinic. Please do not hesitate to call us. Our support staff or one of our specialists will answer any questions you have. We know your child’s health is a high priority. At Portland Anxiety Clinic we are dedicated to helping children and families get the best treatment available.

References

  1. Moleculera labs (2018). PANS and PANDAS overview. Retrieved on November 6, 2019 from https://www.moleculeralabs.com/pans-and-pandas-overview/
  2. Swedo, S.E., Rapoport, J.L., Leonard, H., Lenane, M., & Cheslow, D. (1989). Obsessive- compulsive disorder in children and adolescents. Clinical phenomenology of 70 consecutive cases. Archives of General Psychiatry, 46(4), p. 335-341.