What is PANDAS?
Imagine your child waking up one morning and they seem completely different. Not a gradual change but an immediate change. Their language may be different, the way they are talking can be different, they are mentioning fears they’ve never mentioned before, their choosing not to eat, they are raging with anger, their anxiety is out of control, they may be doing a lot of tics. They may even have some psychotic symptoms such as seeing or hearing things. It may look like full-blown OCD symptoms all in one night. These personality changes can change in an instant.
Let's talk about PANDAS. No not that kind of panda. You may or may not have heard of this. PANDAS stands for: are you ready for this:
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections
Say that five times fast.
Pandas occurs when the strep virus triggers a misdirected immune response and results in inflammation on the child’s brain. Neurologists believe it affects the basal ganglia of the brain. It is Estimated that one and two children may be affected.
A clinical diagnosis of PANDAS is defined by the following criteria:
• Presence of significant obsessions, compulsions, and/or tics
• Abrupt onset of symptoms
• Happens before puberty
• There is an association with a strep infection
Obviously, the strep virus is very common. Many children get step. This doesn’t mean they automatically have pandas.
When looking for strep, did you know that it can occur and reside in somebody’s sinuses, their ears, their gut, or in other areas of their body. So when individuals get a throat swab, the strep virus maybe missed. It has been said that the majority of strep infections are missed.
Individuals may do blood work to see the amount of titers. An elevated anti-strep titer means the child has had a strep infection sometime within the past few months, and his or her body created antibodies to fight the strep bacteria.
Some children create lots of antibodies and have very high titers (up to 2,000), while others have more modest elevations.
One of the most common diagnostic tools I have seen individuals use is called the Cunningham panel. This tests the likelihood of the child having PANDAS.
So here’s the dealio, a lot of emails and phone calls I get regarding pandas start like this…. “do you believe that pandas exists” --- is not such an interesting question? People ask this because there is a lot of information and even doctors who say that this does not exist. While I am not a medical doctor, but in the licensed professional, I have seen many individuals come through my office who exhibit a sudden onset of OCD symptoms and or tics. Sometimes mixed with rage and anger. Sometimes mixed with psychosis. And what I mean sudden onset, I mean sometimes literally overnight.
How scary and confusing this is for parents. For me, I absolutely believe that pandas exists, according to research that I’ve studied as well as individual cases that I have. Because this is what I see, an individual with all of the symptoms is going through what they call a “flare” - where symptoms may increase and last for typically 5 to 6 weeks and then gradually dies out. This may be the time where they were exposed to other viruses or the strep virus in their body is elevated.
This is a pattern that an individual may go through time and time and time again. Typically these infections dictate the need of an antibiotic. Penicillin seems to be the first choice because it is well studied. I wouldn’t believe it if I haven’t seen it with my own eyes, but when an individual starts their antibiotics, their symptoms start decreasing. The treatment that we are working on tends to work much better.
Individuals may do what is called IVIG. It essentially is an IV that injects immunoglobulin, some say this is been able to reset the immune system. This is made from thousands of human donors.
So as far as the medical side goes, in individual may see an OCD therapist to take care of some of those symptoms. We use exposure and response prevention. To teach the brain to respond completely different to the anxiety and fears that come their way. Individuals that experience pandas will have different OCD themes. These can be seen just the same as somebody that has OCD.
So ultimately, what I want to get you to know out of this whole video is this. Get proper treatment if possible. Exposure and response prevention for the OCD symptoms, CBIT for the tics and a medical trained professional for the physical body and brain. I tend to go to the pandasnetwork.org to find a professional near you. With the information I provided, this is just scratching the surface.
Parents trying to navigate through this, you are not alone. I hope this video is helpful for you. If your child is struggling with OCD type symptoms, please watch some of my other videos that might relate to what they are going through.
Here’s my question for you? What you think of pandas? Have you or someone you know experienced this before?
Strep and OCD
Treatment for PANDAS
Nathan Peterson specializes in working with OCD and Anxiety related disorders and has done so for the past 7+ years.