Tiffany Haney
PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is a rare condition that can cause a range of neurological and psychological symptoms in children. While seizures are not a primary symptom of PANDAS, there is some evidence to suggest that the condition may, in some cases, lead to seizures. Several accounts describe children experiencing frontal lobe seizures in connection with PANDAS, with one parent noting that their child's seizures occurred mostly before falling asleep or upon awakening after 4-6 hours of sleep. While the exact causes of PANDAS are not fully understood, it is believed to be triggered by an immune response that leads to inflammation in the brain.
| Characteristics | Values |
|---|---|
| PANS and PANDAS | Episodic disorders with symptoms that may disappear and then reappear |
| PANDAS | A specific type of PANS caused by a strep infection |
| PANDAS | A form of autoimmune encephalitis (AE) |
| AE | Serious debilitation and extreme neurological changes, including seizures |
| PANDAS | Can lead to seizures |
| PANDAS | Can cause frontal lobe seizures |
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What You'll Learn
PANDAS is a form of autoimmune encephalitis
PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections, is a type of autoimmune encephalitis triggered by strep infections, which can result in neuropsychiatric symptoms. It is a subtype of PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) and is specifically associated with an infection from streptococcal (strep) bacteria, such as strep throat or scarlet fever.
PANDAS is believed to be caused by a strep infection, where the immune system, while fighting the infection, mistakenly attacks healthy areas of the body, including the brain. This can lead to the sudden development of OCD, tics, and other symptoms. The symptoms of PANDAS usually present suddenly and intensely and can get better and then worse again, in an episodic manner. They can include compulsions (repetitive behaviours a person feels the urge to do), obsessions (uncontrollable and recurring thoughts), mood swings, irritability, aggression, anxiety, sleep disturbances, and more.
PANDAS is increasingly recognised as a form of autoimmune encephalitis, specifically post-infectious basal ganglia encephalitis (BGE). Studies suggest that PANDAS and Sydenham's chorea are manifestations of basal ganglia encephalitis provoked by cross-reactive anti-neuronal antibodies. The role of Group A streptococcal (GAS) bacteria in PANDAS is being elucidated by Dr Agalliu and his colleagues at Columbia University. They have shown that recurrent GAS infections produce neuroinflammation directly by activating inflammatory cells and indirectly by opening the blood-brain barrier to allow the entry of cross-reactive antibodies to the basal ganglia.
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PANDAS is caused by a strep infection
PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a subtype of PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome). It is believed to be caused by a strep infection, specifically an infection from streptococcal (strep) bacteria, such as strep throat or scarlet fever.
PANDAS is an autoimmune response to a strep infection. When the body's immune system fights the infection, it may mistakenly attack healthy areas of the body, including the brain. This can lead to brain inflammation and autoimmune processes that affect central nervous system function, resulting in neuropsychiatric symptoms. These symptoms can include obsessive-compulsive disorder (OCD), tics, anxiety, mood changes, and other abnormal movements or personality changes.
The symptoms of PANDAS usually present suddenly and intensely and can get better and then worse again in an episodic manner. They typically first appear in childhood, from age 3 to puberty, and are rare in teenagers and adults. However, it is possible for adults to develop a similar immune-related form of OCD, although this has not been thoroughly studied.
Diagnosing PANDAS can be challenging as there are no lab tests to confirm it. A diagnosis requires a careful medical history and physical examination, evaluating signs, symptoms, and medical history to rule out other known neurological or medical disorders. Treatment involves addressing the underlying cause, managing symptoms, and supporting the immune system. Antibiotics are used to treat the strep infection, and cognitive behavioral therapy and habit reversal training are used for behavioral, psychiatric, and tic disorders.
While seizures are not specifically mentioned as a symptom of PANDAS in the sources provided, one source does mention that PANDAS can lead to long-term effects such as seizures. This source is a first-person account of living with PANDAS and seizures, and the individual mentions that their seizures were terrifying and traumatizing, contributing to medical PTSD.
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PANDAS can cause seizures
PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a subtype of PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome). PANDAS is specifically associated with an infection from streptococcal (strep) bacteria, such as strep throat or scarlet fever. PANS, on the other hand, may be triggered by various infections, immune system issues, or environmental factors. Lyme disease and influenza, for instance, are thought to trigger PANS.
PANDAS and PANS are episodic disorders, meaning that symptoms may disappear and then reappear. The symptoms are usually intense, occur quickly and unexpectedly, and may worsen with multiple recurrences. For a child to be diagnosed with PANDAS, there needs to be a sudden onset or worsening of OCD, tics, or both, and a strep infection. The symptoms of PANDAS include the sudden onset of OCD or severely restricted food intake, emotional lability (mood swings), irritability, aggression, developmental regression, sleep disturbances, tics, and unusual movements.
PANDAS is believed to occur when a child's immune system produces antibodies to fight the bacteria that caused a strep infection. However, these antibodies may also mistakenly attack healthy cells in other tissues because they mimic those of the strep infection. This attack on healthy cells can lead to brain inflammation, causing autoimmune processes that affect central nervous system function. This results in neurological and psychiatric symptoms. Neurological symptoms may include impaired memory and cognition, abnormal movements, seizures, and problems with balance, speech, or vision. Psychiatric symptoms may include psychosis, aggression, inappropriate sexual behaviors, panic attacks, compulsive behaviors, euphoria, fear, and mood changes.
While seizures are not a primary symptom of PANDAS, they can occur as a long-term effect of the disease. This is supported by several first-hand accounts of individuals who developed seizures after being diagnosed with PANDAS. In one account, a parent describes their 2-year-old son's experience with frontal lobe seizures, which occurred mostly before falling asleep or upon awakening after 4-6 hours of sleep. Another individual shares their story of living with PANDAS and seizures, describing the seizures as terrifying and traumatizing, and contributing to their medical PTSD.
It is important to note that PANDAS is a rare disorder, and diagnosing it can be challenging. There is no specific test to diagnose PANDAS, and healthcare providers must rule out many other conditions first. Treatment for PANDAS includes antibiotics for active strep infections, cognitive behavioral therapy for behavioral and psychiatric disorders, and habit reversal training for tics.
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PANDAS is treated with penicillin
PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a rare disease that typically affects children between the ages of 3 and puberty. It is characterised by a sudden onset or worsening of symptoms such as obsessive-compulsive disorder (OCD), tics, anxiety, mood changes, and other neuropsychiatric abnormalities. PANDAS is believed to be caused by a strep infection, which triggers an immune response that mistakenly attacks healthy brain cells, leading to inflammation and autoimmune processes that affect the central nervous system. This can result in serious neurological changes, including seizures.
While PANDAS can be a debilitating disease, it can be treated, and early intervention is crucial to minimise relapses and achieve remission. Antibiotics, such as penicillin, play a vital role in managing PANDAS by eradicating the underlying strep infection and preventing future occurrences. Penicillin is a well-studied prophylactic antibiotic that has been shown to be effective in treating illnesses caused by streptococcal bacteria, such as rheumatic fever and Sydenham's chorea.
In the context of PANDAS treatment, penicillin is often recommended as a first-line therapy due to its established safety profile and efficacy in preventing Group A streptococcal (GAS) infections. Studies have demonstrated that penicillin can significantly reduce the number of neuropsychiatric exacerbations and streptococcal infections in patients with PANDAS. The recommended dosage for penicillin in PANDAS treatment is 250mg orally twice a day (bid). This long-term prophylactic antibiotic use can help prevent future strep infections and manage symptoms in severely affected children, especially those with multiple strep-associated neuropsychiatric exacerbations.
Additionally, penicillin has been shown to improve neuropsychiatric symptoms associated with PANDAS, including OCD, anxiety, and tics. In one study, patients maintained on penicillin for a 12-month period experienced a reduction in neuropsychiatric exacerbations and streptococcal infections, with no reported side effects. This suggests that penicillin may be a safe and effective option for managing PANDAS symptoms and preventing infections that can trigger or exacerbate the condition.
However, it is important to note that the response to antibiotics can vary, and some patients may not show improvement within the initial 10-14 days of treatment. In such cases, physicians may consider an alternate class of antibiotics for an additional treatment period before assessing the patient's response. While penicillin is a valuable tool in managing PANDAS, it is just one aspect of a comprehensive treatment plan, which may also include other antibiotics, IVIG therapy, and non-invasive anti-inflammatory medications to address the various symptoms and underlying causes of the disease.
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PANDAS symptoms include tics and obsessive-compulsive disorder-like behaviour
PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections, is a subtype of PANS (Paediatric Acute-Onset Neuropsychiatric Syndrome). PANS may be triggered by various infections, immune system issues, or environmental factors. PANDAS is specifically associated with a streptococcal (strep) bacterial infection, such as strep throat or scarlet fever.
PANDAS is a rare condition that typically affects children between the ages of 3 and 12, although it can occur in adults. The symptoms of PANDAS are usually intense and occur suddenly and unexpectedly. They can include tics, obsessive-compulsive disorder (OCD)-like behaviours, and other abnormal movements. The onset of symptoms can be abrupt, with symptoms reaching full intensity in a few days, followed by a slow, gradual improvement.
The exact causes of PANDAS are not yet known, but one theory suggests that it is triggered by an immune response that leads to inflammation in the brain. When the immune system fights a strep infection, it may mistakenly attack healthy areas of the body, including the brain. This can lead to the sudden development of OCD, tics, and other symptoms. The symptoms of PANDAS can be debilitating and cause extreme neurological changes, including seizures and problems with balance, speech, or vision.
There have been reports of a connection between PANDAS and seizures, particularly frontal lobe seizures. Some people with PANDAS have experienced seizures that occur during the night or when the individual is in a relaxed state. These seizures can be repetitive and last up to an hour. While PANDAS is not directly associated with seizures as a primary symptom, it is possible to have a comorbid diagnosis of seizures or epilepsy. Stress has also been identified as a potential seizure trigger in individuals with PANDAS.
The treatment for PANDAS includes antibiotics for active strep infections, cognitive behavioural therapy for behavioural and psychiatric disorders, and habit reversal training for tics. Additionally, some individuals with PANDAS and seizures have found success in treating seizures with IVIG (intravenous immunoglobulin) therapy.
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Frequently asked questions
PANDAS stands for "Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections". It is a subtype of PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) and is associated with an infection from streptococcal (strep) bacteria, such as strep throat or scarlet fever.
Yes, PANDAS can lead to seizures. PANDAS is a form of autoimmune encephalitis, and seizures are a known neurological symptom of this condition. However, seizures are not a primary symptom of PANDAS and are typically comorbid with the condition.
Treatment options for PANDAS-related seizures include antibiotics for active strep infections, cognitive behavioral therapy for behavioral and psychiatric disorders, and habit reversal training for tics. Seizures may also be treated with IVIG and penicillin.
