What is PANS/PANDAS?
PANS stands for Pediatric Autoimmune Neurological Syndrome. In short when there is a sudden change in a child’s functioning or a sudden start of psychiatric or behavioral symptoms in a child. PANDAS is a type of PANS in which the sudden start of psychiatric, behavioral and neurological syndrome is because of a Streptococcal infection.
How do you diagnose PANS?
- Abrupt and Dramatic Onset of Obsessive Compulsive Behaviors AND/OR Severely restricted food intake.
At Least 2 of the 7 Minor Criteria
- Emotional Lability/Depression
- Irritability/Aggression Severe Oppositional Behaviors
- Developmental/Behavioral Regression
- Deterioration of school performance
- Motor/sensory abnormalities (tics, dysgraphism)
- Somatic symptoms (sleep problems, urinary issues, abdominal complaints)
What are the causes of PANS?
We do not known the cause of PANS. We have theories that it is caused by an immune system that starts becoming dysregulated. The effects of the immune system activation starting having negative effects on the central nervous system and other areas of the body. The immune system can become problematic because of several reasons. Toxins, infections, endocrine problems or sudden psychological stressors can all cause sudden neuropsychiatric symptoms.
Is there a lab test for PANS?
Unfortunately there is no lab test for PANS. It is a clinical diagnosis which requires a high level of suspicion. It is a diagnosis of exclusion at times, meaning that we have to rule out other causes as the reason for a child’s problems.
What lab tests will be done?
We use some lab tests through CPL or a local laboratory. They might include infectious titers, endocrine testing, nutritional testing, tests of inflammation and standard tests that indicate the status of our body’s various functions. Functional testing like stool testing, food intolerance testing, genetic testing, organic acids testing or nutritional testing is also considered on a case by case basis.
Is PANS treatable?
If it is caught early and there is a clear reason that is discovered then some children even make 100% recovery.
How is PANS treated?
PANS is treated with a treatment team. Each member of the treatment team plays an important role in recovery of a child. There are three main areas of focus for treatment of PAN.
- Immunological modulation
- Antimicrobial treatment
- Mental health treatment
Which experts might be involved in treatment of a child?
Depending on the severity and unique circumstances of the case, some of the disciplines that can be involved in treatment of a child include
- Functional medicine provider
- Nutritionist and Herbalist
- School personnel
- Learning specialists
- Occupational and speech therapists
How do you assemble a team around our child?
We have relationships with various treatment providers in the community and can help guide you in setting up care with some of these disciplines. However, occasionally because of lack of medical resources we are unable to find a discipline that we would like to have included in our team. Fortunately, resources are ever changing, and we try our best to keep up with the latest developments.
What kind of medical treatments do you use with children?
- Lifestyle measures like circadian rhythm support and mindfulness training with children can help build a child’s own resilience.
- Food as medicine can be very powerful in children’s health.
- We also use nutrients like Magnesium, Chromium, Zinc and Iron to help a child make up for any nutritional deficiencies.
- We use evidence based pharmacological measures based on the most recent guidelines.
- Acupuncture can be very effective for children, however sometimes if they are nervous of the needles, using some gentle essential oils can help ground them.
Do children respond to herbs?
Herbal medicine for children is based on using food as medicine. There are some “kiddie herbs” that can help support children’s development.
What other child and adolescent problems do you treat?
We see children dealing with all sorts of issues. We have treated:
- Behavioral problems
- Bipolar disorder
- Substance use problems
Dr. Qazi Javed discusses PANS/PANDAS with the Integrative Psychiatry Austin team. Watch on YouTube: