Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) are complex conditions that can dramatically impact a child’s behavior, emotions, and physical health. Characterized by sudden and severe changes in personality and behavior, these syndromes are believed to be triggered by infections and can be both challenging and alarming for families. In this article, we’ll provide an overview of what PANS/PANDAS is, discuss their potential causes, and explain eight common PANS/PANDAS symptoms to help parents recognize when it may be time to seek professional help.
What is PANS/PANDAS?
PANS and PANDAS are both neuropsychiatric disorders that affect children and are marked by the sudden onset of severe psychiatric symptoms, including obsessive-compulsive behaviors, mood disturbances, and tics.
- PANS: PANS is a broader diagnosis that describes the sudden onset of neuropsychiatric symptoms triggered by various infections, environmental factors, or metabolic issues, not just streptococcal bacteria.
- PANDAS: PANDAS is considered a subset of PANS and is specifically associated with streptococcal infections (such as strep throat). The theory behind PANDAS is that the immune system’s response to the strep bacteria triggers inflammation in the brain, particularly in regions responsible for mood and behavior regulation.
What Causes PANS/PANDAS?
PANS/PANDAS are often thought to be caused by an immune response that, instead of attacking harmful invaders, mistakenly targets parts of the brain. When a child’s immune system responds to certain infections or stressors, antibodies may mistakenly attack areas in the brain involved in emotions and behavior, leading to a sudden onset of PANS/PANDAS symptoms.
Symptoms of PANS/PANDAS
PANS/PANDAS can lead to a variety of symptoms that appear quickly and intensely, often described as “overnight changes” in a child’s behavior. Here are eight key PANS/PANDAS symptoms parents should be aware of:
1. Obsessive-Compulsive Behaviors (OCD)
Children with PANS/PANDAS may develop obsessive-compulsive behaviors almost overnight. These behaviors might include excessive hand-washing, checking, counting, or repetitive actions that the child feels compelled to perform. Unlike other forms of OCD that develop gradually, PANS/PANDAS-related OCD is marked by sudden onset, with behaviors that can be extremely disruptive to daily life.
When to Consult a Doctor: If your child develops severe, sudden compulsions or irrational fears that interfere with their ability to function, it may be time to seek medical help.
2. Severe Anxiety
Children with PANS/PANDAS often experience intense anxiety, which can be generalized or specific to certain situations, such as social gatherings, school, or even being away from family members. This anxiety may appear unexpectedly and can lead to panic attacks, refusal to go to school, or extreme clinginess.
When to Consult a Doctor: If your child displays extreme anxiety that prevents them from participating in normal activities or disrupts family life, a medical evaluation could help determine if PANS/PANDAS is involved.
3. Sudden Mood Swings and Irritability
Children with PANS/PANDAS frequently experience sudden and severe mood swings. They may alternate between extreme sadness, irritability, and anger without apparent cause. These mood shifts can happen several times a day and are often disproportionate to the situations they are reacting to.
When to Consult a Doctor: If your child’s moods become unpredictably volatile or if you notice a marked change in temperament, especially alongside other PANS/PANDAS symptoms, consider seeking professional guidance.
4. Tics and Abnormal Movements
Tics, such as sudden jerking movements or vocal sounds, are common in children with PANS/PANDAS. These tics may range from blinking and shoulder shrugging to more complex, repetitive actions or sounds. Tics associated with PANS/PANDAS can come on suddenly and may fluctuate in frequency and severity.
When to Consult a Doctor: If your child develops tics seemingly out of the blue, especially if accompanied by other neuropsychiatric symptoms, it’s wise to consult a healthcare provider.
5. Regression in Behavior and Skills
Another hallmark PANS/PANDAS symptom is a regression in developmental skills, such as returning to behaviors typically outgrown, such as bedwetting, baby talk, or fear of the dark. Children may also struggle with tasks they previously mastered, such as reading or math.
When to Consult a Doctor: If your child starts exhibiting age-inappropriate behaviors or regresses in skills, especially if other PANS/PANDAS symptoms are present, a doctor’s evaluation is recommended.
6. Sleep Disturbances
Children with PANS/PANDAS often experience significant sleep disturbances. They may have trouble falling asleep, experience frequent nightmares, or wake up frequently during the night. Sleep changes are often accompanied by increased anxiety and may worsen other PANS/PANDAS symptoms, such as irritability and mood swings.
When to Consult a Doctor: If your child’s sleep patterns change dramatically and they are unable to get restful sleep, consider discussing these changes with a doctor.
7. Difficulty with Attention and Concentration
Cognitive symptoms, such as problems with attention and concentration, are common in PANS/PANDAS. Children may struggle to remember things, following instructions, or staying focused on schoolwork. Parents and teachers may notice a sudden drop in academic performance or increased distractibility.
When to Consult a Doctor: If your child displays sudden difficulty concentrating or a decline in school performance that doesn’t improve, especially if other PANS/PANDAS symptoms are present, an evaluation is important.
8. Physical Symptoms (Headaches, Joint Pain, Bedwetting)
PANS/PANDAS can also cause physical symptoms, such as frequent headaches, joint pain, stomachaches, and bedwetting. These physical symptoms may seem unrelated to neuropsychiatric issues but are part of the syndrome’s complex presentation.
When to Consult a Doctor: If your child develops unexplained physical symptoms in conjunction with behavioral or emotional changes, a comprehensive evaluation can help clarify whether PANS/PANDAS may be the cause.
When to Seek Help
If your child exhibits multiple PANS/PANDAS symptoms that emerge suddenly and are markedly different from their usual behavior, it’s important to consult a healthcare provider experienced in PANS/PANDAS. Early diagnosis and treatment can help manage symptoms and improve your child’s quality of life.
Hope for Healing PANS/PANDAS
If you are concerned that your child has PANS/PANDAS, consider contacting Hope for Healing. Hope for Healing understands the unique challenges that PANS/PANDAS present. Using a functional medicine approach, our pediatric care team looks beyond just the symptoms to find and address the root causes of your child’s condition. Through comprehensive testing, we identify infections, immune responses, and other underlying issues that could be contributing to your child’s PANS/PANDAS symptoms. Hope for Healing’s goal is to create a personalized treatment plan that may include lifestyle changes, dietary adjustments, supplements, and therapies to support the immune system, manage inflammation, and improve overall health.
Our functional medicine approach enables us to offer holistic and individualized care, helping children and families navigate the complexities of PANS/PANDAS with compassion and expertise. If your child is experiencing sudden, unexplained behavioral or physical changes, schedule a welcome call with Hope for Healing today to explore a diagnostic and treatment approach tailored to the unique needs of your child and family.
