Pandas: A Real Disease Or Just A Cute Name?

PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a controversial diagnosis for a subset of children who exhibit rapid-onset obsessive-compulsive disorder (OCD) or tic disorders. PANDAS is thought to be triggered by a Group A streptococcal (GAS) infection, which causes the immune system to attack healthy cells in the brain. While some doctors and scientists believe PANDAS is a legitimate disorder, others argue that it is a hoax or a misdiagnosis.

PANDAS is a controversial diagnosis

PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a controversial diagnosis. While it has been a named disease for over 20 years, many doctors still refuse to diagnose PANDAS, claiming it is a hoax.

The controversy surrounding PANDAS stems from the fact that it is a relatively new syndrome, identified following the discovery of Sydenham's chorea. PANDAS is thought to be caused by a Group A strep infection, such as strep throat, scarlet fever, or rheumatic fever, which tricks a child's immune system into attacking their own brain, leading to sudden onset OCD symptoms. However, pediatric neurologists argue that Tourette syndrome and OCD, which PANDAS is often mistaken for, are highly heritable, and if strep plays a role, it is extraordinarily rare. Furthermore, the symptoms of PANDAS can be inconsistent and are not always affected by antibiotics.

Another point of contention is the lack of a definitive test for PANDAS. While there are biological markers that can be used to assess a child's condition, there is no single blood test that can confirm a PANDAS diagnosis. This makes it difficult to distinguish PANDAS from other mental health conditions such as OCD, autism, or Tourette syndrome.

Despite the controversy, there is a growing body of scientific evidence supporting the existence of PANDAS. Research has shown that PANDAS affects as many as 1 in 200 children and can have severe and debilitating symptoms. Treatment options for PANDAS include cognitive behavioral therapy, intravenous immunoglobulin (IVIG), plasmapheresis, removal of tonsils, and antibiotic treatment. However, the use of antibiotics is controversial, as overdiagnosis of PANDAS may have led to their overuse.

In conclusion, while PANDAS is a controversial diagnosis, there is a growing body of evidence supporting its existence as a distinct disorder. More research is needed to fully understand PANDAS and develop effective treatment options.

PANDAS is a real condition affecting children worldwide

PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a real condition affecting children worldwide. It is characterised by a rapid onset of obsessive-compulsive disorder (OCD) or tic disorders, which can be caused by a post-streptococcal autoimmune process. Group A streptococcal (GAS) infections, and more specifically, group A beta-hemolytic streptococcal (GABHS) infections, are thought to be the triggers for these disorders.

PANDAS was first described in 1998 by Susan Swedo and a group of researchers at the US National Institute of Mental Health. It is a controversial diagnosis, with many experts disputing its existence. However, research spanning decades has demonstrated that PANDAS does exist, and it is estimated that more than 1 in 200 children are affected by it.

The symptoms of PANDAS include uncontrolled jerky movements, symptoms of ADHD such as hyperactivity and trouble paying attention, anxiety attacks, behavioural regression, moodiness, irritability, and sensory problems. These symptoms can develop overnight, making it scary for both children and their parents.

The treatment for PANDAS typically involves medication and therapy. Antibiotics are used to treat the underlying strep infection, while anti-inflammatories such as steroid pills and non-steroidal anti-inflammatory drugs (NSAIDs) are used to calm the immune system. Cognitive behavioural therapy is also recommended to help control OCD thoughts and fears. In more severe cases, procedures such as IVIG (infusion of antibodies from other people) or plasmapheresis (filtering blood through a machine to remove harmful antibodies) may be considered.

While PANDAS is a real condition, it is important to note that it is not listed as a diagnosis in the 2013 fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Additionally, as of 2021, the autoimmune hypothesis of PANDAS is not supported by evidence. However, research is ongoing, and PANDAS is recognised as a legitimate disorder by many in the medical community.

PANDAS is an autoimmune disorder

PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is an autoimmune disorder. It is a complex disorder with many different symptoms unique to each patient. PANDAS is a childhood disorder that results from a Group A Streptococcal bacterial infection, commonly known as "strep" or "strep throat".

The underlying cause of PANDAS is thought to be attributed to an autoimmune attack of healthy brain tissue after a strep infection. The antibodies produced by the body in response to the strep infection may cause PANDAS symptoms, not the bacteria itself. This is because the antibodies inadvertently target the child's own healthy tissue in the brain, resulting in abnormal neuronal signalling events. This leads to a decrease in motor control, motor learning, and decision-making, and a sudden increase in emotional or behavioural instability.

PANDAS is most common in children younger than 13 years who have been infected with Group A Strep. The symptoms of PANDAS include obsessive thoughts, compulsive behaviours, and motor or vocal tics. These symptoms can be accompanied by a variety of other neuropsychiatric symptoms such as separation anxiety, moodiness/irritability, and anxiety attacks. The symptoms usually become more intense within 24-48 hours after the onset of their Group A Strep infection.

PANDAS is diagnosed by a healthcare provider after evaluating the patient. Although there are no lab tests that can diagnose PANDAS, diagnostic criteria include the presence of OCD or a tic disorder, paediatric onset of symptoms (between the ages of 3 and puberty), and an association with a Group A Beta-hemolytic strep infection.

PANDAS is a controversial condition, with many experts disputing its existence. However, research spanning decades demonstrates that the condition does exist, and PANDAS has been recognised as a named disease for over 20 years.

PANDAS is a severe disorder

PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a severe disorder that affects children between the ages of 3 and 13. It is characterised by the abrupt onset of neuropsychiatric symptoms, specifically obsessive-compulsive disorder (OCD) or tic disorders. These symptoms can develop overnight and can be frightening for both children and their parents.

PANDAS is triggered by a Group A streptococcal (GAS) infection, such as strep throat, scarlet fever, or rheumatic fever. This infection tricks the child's immune system into attacking the basal ganglia of their own brain, leading to the onset of OCD and related symptoms. The symptoms of PANDAS are so severe and dramatic that they are immediately obvious to those around the child. Many children with PANDAS need to stay home from school until they find the proper treatment and support.

The severity of PANDAS is further emphasised by the fact that it can lead to chronic autoimmune disease if left untreated. Additionally, the symptoms can far outlast the course of a strep infection, and PANDAS can return if the child gets another strep infection. The impact of PANDAS can be significant, affecting the child's ability to function and causing them to exhibit uncontrolled emotions, irritability, anxiety, and loss of academic ability and handwriting skills.

While there is ongoing debate about the existence of PANDAS, with some doctors refusing to recognise it as a legitimate diagnosis, there is a growing body of research supporting its validity. Treatment for PANDAS typically involves a combination of medication and therapy, and most children who receive treatment are likely to make a full recovery.

PANDAS is a subset of PANS

PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is indeed a real disease. It is a subset of PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome. PANDAS was first reported by a team at the National Institute of Mental Health in 1998 and has been classified as a subset of PANS.

PANDAS is characterised by the abrupt onset of OCD or dramatic, disabling tics; a relapsing-remitting, episodic symptom course; young age at onset (average of 6-7 years); presence of neurologic abnormalities; and a temporal association between symptom onset and Group A strep (GAS) infection. The five criteria are usually accompanied by similar comorbid symptoms as found in PANS.

PANS, on the other hand, is a clinically defined disorder characterised by the sudden onset of obsessive-compulsive symptoms (OCD) or eating restrictions, along with acute behavioural deterioration in at least two designated domains. Comorbid PANS symptoms may include anxiety, sensory amplification or motor abnormalities, behavioural regression, deterioration in school performance, mood disorder, urinary symptoms, and/or sleep disturbances. While PANS does not require a known trigger, it is believed to be triggered by one or more pathogens.

Both PANS and PANDAS are neuropsychiatric conditions, meaning they are medical conditions with both neurological and psychiatric symptoms. They are often grouped together because they share many symptoms, and both conditions can begin quite suddenly, with symptoms coming and going over time.

PANDAS and PANS are commonly misunderstood and stigmatised in the medical community, with many doctors refusing to diagnose or treat them. However, there is an abundance of scientific evidence supporting the existence of these conditions, and research continues to improve our understanding of them.

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