PANDAS / PANS / AutoImmune Encephalitis
About
PANDAS / PANS
PANDAS (also known as Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection) and PANS (or Pediatric Acute-onset Neuropsychiatric Syndrome) are two conditions that are typically characterized by a sudden and dramatic onset of the following symptoms:
- Obsessive Compulsive Disorder (OCD)
- Anxiety, separation anxiety and irrational fears
- Tics (motor and/or verbal) and Tourette Syndrome
- Food restriction
- Oppositional Defiant Disorder (ODD)
- Sensory sensitivity and Sensory Processing Disorder (SPD)
- Depression, irritability, aggression
- Hyperactive energy/new onset of ADHD-like symptoms
- Intrusive thoughts
- Self-Injurious behaviour
- Behavioural regression
- Deterioration in performance at school/handwriting regression
- Urinary frequency, urgency, accidents or bedwetting
- Hallucinations
PANDAS is a diagnosis that follows a Group A Beta-Hemolytic Streptococcal infection (such as Strep throat, Scarlet Fever, Streptococcal pneumonia, perianal Strep, or Strep impetigo) however not every child diagnosed with PANDAS has a confirmed Strep throat history or a positive Strep test.
PANS is a similar condition, associated with an infectious trigger other than Streptococcus, which may include Mycoplasma pneumonia, viral infections, or Borrelia (Lyme disease) and other tick or vector-borne co-infections (Bartonella, Ehrlichia, Anaplasma, Babesia and others).
Testing + Support
Tests
The following tests may be warranted, depending on the case:
- Strep throat swab and culture
- Strep antibody titres: Antistreptolysin-O titer (ASOT), Anti-DNase B Antibody titer
- Testing for other infections such as: Mycoplasma, Lyme disease and co-infections, Herpes Simplex Virus (HSV) I and II, Human Herpes Virus (HHV6), Epstein Barr Virus (EBV), Cytomegalovirus (CMV), Coxsackievirus
- ANA autoimmune test
- Food Sensitivity Panel
- Testing for celiac disease
- Stool analysis for bacterial and yeast overgrowth, beneficial bacteria levels and parasitology
- Additional Strep swabs: nasal, teeth/gums/tongue, perianal, stool
- Organic Acids Testing
- Cunningham Panel
- Neurotransmitter testing
- Mycotoxin testing for mold exposure
- Histamine testing
Support
Supportive treatment strategies for PANDAS and PANS are unique to the needs of each child. A general Naturopathic protocol may include:
- Antibiotic therapy (Prescription available in BC only or via referral to NP in ON)
- Herbal antimicrobials
- Probiotics
- Natural or pharmaceutical neurotransmitter support (Prescription available in BC only or via referral to NP in ON)
- Immune support and immune system modulation
- Natural, OTC, and prescription anti-inflammatories (Prescription available in BC only or via referral to NP in ON)
- Gut healing program for digestive tract inflammation, infection, dysbiosis (bacterial imbalance), IBS, or leaky gut syndrome
- Dietary modifications such as anti-inflammatory diet, low sugar diet, low histamine diet or low glutamate diet
- Anti-parasitic treatment
- Biofilm disruption in the gastrointestinal tract
- Nasal/sinus sprays to kill bacteria, fungal overgrowth and disrupt sinus biofilms
- Antibiotic and antimicrobial mouth rinses (Prescription available in BC only or via referral to NP in ON)
- Other recommendations not offered by High Five Family Health: Cognitive Behavioural Therapy, IVIG, Plasmapheresis