PANDAS – 6 Questions Parents Must Know

What is it?

PANDAS, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a kind of pediatric autoimmune neuropsychiatric disorder, which is related to streptococcus.

If your kids are suffering from an infection involving streptococcus pyogenes (streptococcal-A infection), you should pay more attention to any changes in their personality, behavior or movement.

Generally, full recovery after strep infection is not that hard.However, if your kids develop sudden physical and psychiatric symptoms several weeks after infection, you should never ignore these symptoms and it’s better to ask for professional treatments as soon as possible.


What are the symptoms?

Symptoms often occur suddenly during 4 to 6 weeks after a strep infection, including the following two.

Physical symptoms may include:

  • tics and unusual movements
  • sensitivities to light, sound, and touch
  • deterioration of small motor skills or poor handwriting
  • hyperactivity or an inability to focus,or near catatonic state
  • trouble sleeping,memory problems,refusing to eat, which can lead to weight loss
  • joint pain,frequent urination and bedwetting

Psychological symptoms may include:

  • obsessive, compulsive, and repetitive behaviors
  • separation anxiety, fear, and panic attacks
  • incessant screaming, irritability, and frequent mood changes
  • emotional and developmental regression
  • visual or auditory hallucinations, depression and suicidal thoughts

Not all the symptoms occur at the same time, but a mix of several physical and psychiatric symptoms can define your kids’ PANDAS.


What causes it?

It results from an autoimmune response to a strep infection and the exact cause is undergoing research.


Who’s at risk?

You should stay more careful if your kids:

  • age between 3 and 12 years old with a strep infection within the last 4 to 6 weeks.
  • suffer from some recurrent infections
  • are more likely to get the probelms in late fall and early spring.

So it’s important for you to teach your children to not to share eating utensils or drinking glasses, or to wash their hands often against step infection. Besides, they should avoid touching their eyes and face whenever possible.


How is it diagnosed?

For sure, the best way to diagnose the disease is to make an appointment with your pediatrician right away. It would be very helpful if you keep a journal detailing these symptoms of your kids. However, there are no laboratory or neurological tests to diagnose PANDAS.

Here are some criteria for diagnosis:
1. previous or current strep-A infection, confirmed by a throat culture or blood test
2. being between three years old and puberty
3. sudden onset or worsening of already existing symptoms, with symptoms becoming more severe for periods of time
4. specific neuropsychiatric symptoms, such as hyperactivity, mood changes, developmental regression, or anxiety
5. presence of obsessive-compulsive behaviors, tic disorder, or both


What’s the treatment?

When it comes to the treatment, curing the strep infection ranks first. You better find a specialist familar with OCD and PANDAS. Strep infections treatment needs antibiotics, and generally a single course would be enough.

Here are the common antibiotics :

  • penicillin
  • amoxicillin
  • cephalosporin
  • azithromycin

The next step would be psychological symptoms relief. Cognitive behavioral therapy is useful in the OCD and other psychiatric symptoms. Also, you can use some antibiotics to relieve the symptoms, such as sertraline, paroxetine, fluoxetine, fluvoxamine. About the dose, you shoul stay alert and ask for your doctor’s advice on increasing them.

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.