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Back in 1998, a team from the National Institute of Mental Health uncovered a condition known as PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections).

The PANDAS Strep Connection

PANDAS isn’t a disease that your child “catches”. It all starts with an immune response triggered by a strep infection. So yes, streptococcal bacteria is at the heart of PANDAS. But it’s not the strep infection itself that causes problems; it’s your child’s immune response to that bacteria.

Kids have resilient immune systems, but strep bacteria can outsmart them by disguising itself as familiar body molecules. Once the immune system detects the imposters, it launches an attack by creating antibodies specific to the pathogen. But the confusion doesn’t necessarily stop there. The immune system may end up attacking the brain while trying to combat the strep infection. This type of response is called “autoimmune” — where the immune system targets specific body cells that resemble an unwanted pathogen. Then even once the pathogen has been eradicated, the attack on the body continues.

Researchers think the PANDAS strep connection happens when the immune system attacks cells in the basal ganglia, the part of the brain that controls learning and movement. The damage may be behind the psychiatric symptoms of PANDAS.

PANDAS is connected to strep. So if your child has PANDAS, they have dealt with a strep infection. But it’s important to note that PANDAS can take up to six months to manifest after a strep infection. And it’s possible for your child to have strep without you even knowing it. Commonly, strep infects the throat, but it can affect other areas as well.

PANDAS Symptoms

PANDAS symptoms strike suddenly, leaving parents bewildered by the drastic change in their once cheerful child. If your child is affected by PANDAS, you may notice some of the following:

Abrupt Personality Changes

Your once happy and well-adjusted child may exhibit sudden mood swings, irritability, or anxiety.

Obsessive Thoughts and Compulsive Behaviors

Your child may develop obsessions or compulsions that interfere with daily life, such as repetitive rituals or an intense focus on cleanliness.

Motor Tics

Involuntary movements, such as eye blinking, facial grimacing, or jerking motions, may appear out of the blue.

Behavioral Regression

Skills or behaviors your child had previously mastered may regress — such as bedwetting, separation anxiety, or loss of fine motor control.

Cognitive Difficulties

PANDAS can lead to difficulties with attention, memory, and concentration.

Diagnosing PANDAS

There is no specific lab test practitioners can use for diagnosing PANDAS. Instead, a knowledgeable practitioner will rely on a clinical evaluation — considering the symptoms, medical history, and related lab results. Since PANDAS is triggered by strep infection, the physician will likely conduct a strep throat culture and a Cunningham Panel to check for antibodies.

When diagnosing PANDAS, the doctor will assess the following five criteria:

📝 Significant obsessions, compulsions, and/or tics

📝 Symptoms appear suddenly or follow a pattern of varying severity

📝 Symptoms emerge before puberty, usually around 6-7 years of age

📝 A previous streptococcal infection is noted

📝 Other neuropsychiatric symptoms such as hyperactivity, anxiety, mood changes, or developmental regression

Healing PANDAS is Possible

If your child has already been diagnosed, or you suspect PANDAS could explain sudden changes in behavior, there is hope and support available for healing PANDAS. Over the next few weeks, I’ll delve deeper into some of the most common symptoms of PANDAS, and a closely related disease called PANS.

I know you really want solutions — things you can do to help your child quickly. So I’ll also share practical suggestions based on what I’ve learned through years of working with PANDAS-affected children.

While dealing with PANDAS can be challenging, it’s important to remember that progress is possible. With the right interventions, patience, and a strong support system, you can make a positive impact on your child’s well-being. And I’m here to support you every step of the way.

If you’re wondering if your child’s symptoms might add up to more than just a behavioral issue or developmental phase consider taking my free PANS/PANDAS quiz.

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