Ella Walter
PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections) are autoimmune conditions that affect children and result in neuropsychiatric disorders. The cause of PANS is unknown in most cases but is thought to be triggered by infections, metabolic disturbances, and other inflammatory reactions. PANDAS, on the other hand, is triggered specifically by a faulty immune response to streptococcal infections. These disorders can cause a range of symptoms, including obsessive-compulsive disorder (OCD), tics, anxiety, depression, irritability, and difficulty with schoolwork. While the exact mechanisms are not fully understood, it is believed that these conditions may involve disruptions in neurotransmitter activity within the brain.
| Characteristics | Values |
|---|---|
| Name | Pediatric Acute-onset Neuropsychiatric Syndrome |
| Alternative Names | PANS, PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections), AE (Autoimmune Encephalopathy) |
| Type | Autoimmune condition |
| Age Group | Children |
| Symptoms | OCD, tics, depression, irritability, anxiety, difficulty with schoolwork, loss of academic ability, uncontrollable emotions, loss of handwriting skills, incontinence, abnormal urinary frequency, violent behaviour, paranoia, hallucinations, movement disorders, seizures, irregular heartbeat and breathing, coma |
| Causes | Unknown in most cases, thought to be triggered by infections, metabolic disturbances, inflammatory reactions, toxins, autoimmune response |
| Diagnosis | No lab test available; diagnosis based on symptoms and ruling out other conditions |
| Treatment | Neurofeedback, anti-inflammatory diet, magnesium, serotonin uptake inhibitors, steroids, IVIG, chemotherapy drug Rituximab, immunotherapy |
| Support | The Brain Charity, Stanford Medicine |
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What You'll Learn
- PANS/PANDAS is an autoimmune condition that affects children and results in neuropsychiatric disorders
- The cause of PANS is unknown but is thought to be triggered by infections, metabolic disturbances, and inflammatory reactions
- PANDAS is a subset of PANS, triggered by a faulty immune response to streptococcal infections
- Neurofeedback sessions can help regulate the brain of someone impacted by infection or toxins
- Magnesium can be helpful in managing PANS/PANDAS symptoms by inhibiting the release of excitatory neurotransmitters and increasing serotonin
PANS/PANDAS is an autoimmune condition that affects children and results in neuropsychiatric disorders
PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome, is a clinical diagnosis given to children who experience a dramatic and sudden onset of neuropsychiatric symptoms. PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections, is a subset of PANS and is characterised by similar symptoms, specifically OCD or tics, that develop within 2 to 3 days. While the cause of PANS is unknown in most cases, it is thought to be triggered by infections, metabolic disturbances, and other inflammatory reactions. PANDAS, on the other hand, is associated with streptococcal infections such as strep throat, peri-anal strep, or scarlet fever.
Both PANS and PANDAS are autoimmune conditions that can result in neuropsychiatric disorders in children. PANDAS is the only known subtype of PANS, but there may be other causes discovered in the future. The symptoms of PANS and PANDAS can vary from patient to patient but usually present suddenly and intensely, with some children experiencing episodic symptoms that get better and then worse again. In addition to OCD or tics, children with PANS or PANDAS may also exhibit symptoms such as irritability, anxiety, depression, sleep disturbances, deterioration of motor skills, visual or auditory hallucinations, and loss of academic ability.
The treatment of PANS and PANDAS involves a combination of approaches, including antibiotics to treat active infections, cognitive behavioural therapy, and habit reversal training for tics. Intravenous immunoglobulin (IVIG) therapy has also been proven to help the majority of children with PANS or PANDAS by boosting the immune system and reducing inflammation in the brain. Additionally, neurofeedback sessions can help regulate the brain by influencing neurotransmitter activity and calming the nervous system, allowing children to learn new ways of responding emotionally.
The diet can also play a crucial role in managing PANS and PANDAS. Eating foods rich in polyphenols, such as fruits, vegetables, herbs, spices, tea, and dark chocolate, can reduce inflammation and protect neurons against injury induced by neurotoxins. Magnesium, in particular, is essential in managing symptoms of OCD by inhibiting excitatory neurotransmitters and increasing serotonin levels.
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The cause of PANS is unknown but is thought to be triggered by infections, metabolic disturbances, and inflammatory reactions
The cause of Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is unknown in most cases. However, it is believed to be triggered by infections, metabolic disturbances, and inflammatory reactions.
PANS is a clinically defined disorder characterized by the sudden onset of obsessive-compulsive symptoms (OCD) or eating restrictions, along with acute behavioural deterioration in at least two designated domains. It is often misdiagnosed as OCD, an eating disorder, or attention-deficit/hyperactivity disorder (ADHD). However, the sudden onset of symptoms separates PANS from these other disorders.
In addition to OCD or eating restrictions, children with PANS may also experience anxiety, sensory amplification, motor abnormalities, behavioural regression, deterioration in school performance, mood disorders, urinary symptoms, and/or sleep disturbances. These symptoms can have a significant impact on the child's daily life, including their performance at school and their relationships with others.
PANS is believed to be triggered by infections, metabolic disturbances, and inflammatory reactions. In particular, it has been associated with a variety of infectious agents, including influenza, varicella, mycoplasma pneumoniae, and Lyme disease. Strep infections are also a common trigger, with "strep throat" infections being the most frequently reported. Other potential triggers include defects in clearing Group A strep, differences in neurocircuitry, cytokine receptors in the brain, and abnormal expression of neurosignalling molecules/receptors during infection.
The treatment of PANS often involves immunomodulatory therapies and the prevention of infections. Additionally, an anti-inflammatory diet is recommended for children with PANS, as it can help to reduce inflammation and protect neurons against injury induced by neurotoxins.
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PANDAS is a subset of PANS, triggered by a faulty immune response to streptococcal infections
PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome, is a clinical diagnosis given to children who experience a dramatic and abrupt onset of neuropsychiatric symptoms. The cause of PANS is unknown in most cases, but it is believed to be triggered by infections, metabolic disturbances, and other inflammatory reactions.
PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a subset of PANS. It was first reported by a team at the National Institute of Mental Health in 1998. PANDAS is triggered by a faulty immune response to streptococcal infections, specifically Group A Beta-hemolytic strep infections, such as strep throat or scarlet fever. The onset of symptoms in PANDAS is often rapid, with obsessive-compulsive disorder (OCD) or tic symptoms suddenly appearing or worsening within 24 to 48 hours of the infection. In addition to OCD or tic disorders, children with PANDAS may experience mood swings, irritability, anxiety, and academic difficulties.
The pathophysiology of PANDAS involves the production of cross-reactive antibodies that target both the strep bacteria and similar molecules found in the child's own body. These antibodies can enter the brain and target specific brain receptors, such as dopamine receptors, leading to neuropsychiatric symptoms. Studies have shown that some of these antibodies target the brain, causing OCD, tics, and other neuropsychiatric manifestations of PANDAS.
The diagnosis of PANDAS is based on clinical features, as there are no specific laboratory tests available. However, blood tests may be performed to document a preceding strep infection if symptoms have been present for more than a week. The treatment of PANDAS focuses on addressing both the physical and psychiatric symptoms. Supplemental treatments include tonsillectomy to prevent further streptococcal infections, and immunomodulatory therapies such as corticosteroids, therapeutic plasma exchange (TPE), intravenous immunoglobulin (IVIG), or anti-CD20 monoclonal antibodies (rituximab) to suppress the immune system and reduce OCD symptoms.
While PANDAS is a well-defined subset of PANS, it is important to note that the validity of the PANDAS diagnosis has been debated. The distinction between PANS and PANDAS may become less important as research progresses, and a broader understanding of the role of infectious agents in neuropsychiatric disorders emerges.
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Neurofeedback sessions can help regulate the brain of someone impacted by infection or toxins
Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is a clinical diagnosis given to children who experience a dramatic and sudden onset of neuropsychiatric symptoms. PANS is thought to be triggered by infections, metabolic disturbances, and other inflammatory reactions.
PANS/PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections) is frequently misdiagnosed as other disorders such as OCD, ADHD, depression, and anxiety. The symptoms of PANS/PANDAS can be managed through neurofeedback sessions.
Neurofeedback, also known as EEG (electroencephalogram) biofeedback, is a therapeutic intervention that uses computer programs to assess and provide feedback on a client's brainwave activity. The program uses auditory or visual signals to help patients recognize and modify their thought patterns. Through this process, clients can learn to regulate and improve their brain function and alleviate symptoms of various neurological disorders and mental health conditions.
Neurofeedback impacts brain waves, influences neurotransmitter activity, and calms the nervous system. It addresses dysfunction in brain structures, such as impulse control and executive functioning in the frontal lobes. It can help patients pay attention, calm racing thoughts, and respond more appropriately to stimuli.
Neurofeedback is a non-invasive and medication-free approach that encourages the brain to develop healthier patterns of activity. It is important to work with a highly skilled neurofeedback provider, as it requires a tremendous amount of experience to understand how to regulate the brain of someone impacted by infection or toxins.
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Magnesium can be helpful in managing PANS/PANDAS symptoms by inhibiting the release of excitatory neurotransmitters and increasing serotonin
Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and its subset, Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS), are conditions that involve a sudden, dramatic onset of neuropsychiatric symptoms in children. These symptoms can include obsessive-compulsive disorder (OCD), tics, irritability, anxiety, depression, and a loss of academic ability and handwriting skills.
While the cause of PANS is unknown in most cases, it is thought to be triggered by infections, metabolic disturbances, and other inflammatory reactions. PANDAS, on the other hand, is associated with a recent streptococcal infection, such as strep throat, peri-anal strep, or scarlet fever.
Magnesium is an essential nutrient that plays a critical role in supporting optimal brain and body function. It is involved in various physiological processes, including the regulation of neurotransmitter systems. In the context of PANS/PANDAS, magnesium can be particularly beneficial in managing symptoms.
Firstly, magnesium inhibits the release of excitatory neurotransmitters. This is important because glutamate, the most abundant excitatory neurotransmitter, has been implicated in many neurological and psychiatric disorders. By blocking the glutamatergic N-methyl-D-aspartate (NMDA) receptor, magnesium helps prevent glutamatergic excitatory signaling, providing neuroprotective effects. This blockade can be beneficial in calming down the excitatory neurotransmitters associated with OCD, which is a common symptom of PANS/PANDAS.
Secondly, magnesium increases serotonin levels in the brain. Serotonin is a neurotransmitter that plays a crucial role in mood and mental health regulation. Magnesium acts as a cofactor for tryptophan hydroxylase, which is involved in serotonin synthesis. It also exhibits a direct enhancing effect on serotonin receptor transmission. By increasing serotonin levels, magnesium can help improve mood disorders, anxiety, and depression, which are commonly observed in individuals with PANS/PANDAS.
In addition to its direct effects on neurotransmitters, magnesium also provides neuroprotective benefits. It helps counteract oxidative stress, inhibits the release of inflammatory molecules, and promotes neuronal survival and growth. These effects can be particularly advantageous in mitigating the neuroinflammatory consequences of PANS/PANDAS.
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Frequently asked questions
PANS stands for Pediatric Acute-onset Neuropsychiatric Syndrome. It is a clinical diagnosis given to children who have a dramatic and sudden onset of neuropsychiatric symptoms.
The symptoms of PANS include obsessive-compulsive disorder (OCD), severely restricted food intake, sudden deterioration in academic performance, and not being able to control urination and/or abnormal urinary frequency. Children with PANS may also experience symptoms of depression, irritability, anxiety, and uncontrollable emotions.
The cause of PANS is unknown in most cases but is thought to be triggered by infections, metabolic disturbances, and other inflammatory reactions. PANS is caused by a faulty immune response in which antibodies attack the brain, leading to inflammation and neuropsychiatric symptoms.
Treatment for PANS involves working with a highly skilled neurofeedback provider to regulate the brain and address dysfunction in brain structures, such as impulse control and executive functioning. Diet can also play a role in treating PANS by regulating neurotransmitter pathways, synaptic transmission, membrane fluidity, and signal transduction pathways. Support groups are also available for individuals and families affected by PANS.
