PANDAS

 

Understanding

 
PANDAS - Wikipedia - Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) - is a hypothesis that there exists a subset of children
with rapid onset of obsessive-compulsive disorder (OCD) or tic disorders and these symptoms
are caused by group A beta-hemolytic streptococcal (GABHS) infections.
07/20/18: PANDAS A new psychiatric disorder due to strep throat -
Parents fear for young children's safety as their behavior changes dramatically; Rare disorder...

https://abc.go.com/shows/2020/episode-guide/2018-07/20-072018-pandas
significant video
https://www.babble.com/parenting/pandas-disorder-abc-news-special/
editorial
 
 

Conventional Medicine/Research

 
Autism Speaks -
https://www.autismspeaks.org/blog/2014/04/04/what-pandas-how-it-different-autism (edited)
PANDAS turned out to be the cause of new obsessive-compulsive symptoms in our son, who also has autism.  The lack of information and awareness left his symptoms untreated for nearly 3 years’…
In 1998, Dr. (Susan) Swedo and her colleagues coined the term PANDAS to describe 50 cases of a rare syndromePANDAS is an acronym for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections.
These disorders involve the sudden onset of obsessive-compulsive disorder (OCD) or tics in children
following a strep infection such as strep throat or scarlet fever…
We’re researching a theory that the mechanism is similar to that behind rheumatic fever,
another autoimmune disorder triggered by strep infections. 
In any bacterial infection, the body produces antibodies against the invading microbes.
Antibodies help eliminate the (excessive bad) bacteria from the body.
Unfortunately, certain proteins on a strep bacterium’s cell wall resemble certain proteins on human cells.  This can cause the immune system to mistakenly attack healthy tissue.
In rheumatic fever, antibodies mistakenly attack the heart valves, joints &/or certain parts of the brain. 
PANDAS may involve strep antibodies interacting with the part of the brain known as the basal ganglia.  This, we believe, is what causes the sudden onset of tics or obsessive compulsive behaviors…
PANDAS may be mistaken for classic OCD…In an autistic child…
What distinguishes PANDAS from autism symptoms or classic OCD is the
sudden onset of symptoms

PANDAS tends to resolve on its own once the strep infection is treated with appropriate antibiotics…
Aggressive treatments such as plasma exchange and immunoglobulin (IVIG) have been effective
in treating severe, strep-triggered OCD and tics. But these treatments come with serious side effects.
So their use should be reserved for severely ill patients and administered only by highly experienced
health-care professionals. In addition, standard treatments for classic OCD
can help ease the symptoms of PANDAS, including cognitive behavioral therapy."
 
DSM#5 http://childadvocate.net/pandas-identification-and-possible-treatment/ (edited)
"Patient must meet lifetime diagnostic criteria (DSM V) for OCD or tic disorder.
Pediatric onset of symptoms must 1st be evident between ages 3 and beginning of puberty...
Patient must have a lifetime pattern of exacerbeted symptoms, (initially) related to GABHS infection (& subsequently diagnosed via throat culture or rise in antibody titers).
Patient must evidence an abnormal neurological exam (i.e. – choreiform movements or tics) during exacerbation" (relapse/psychotic episode)...
Conclusion: Both plasma exchange and IVIG were effective in significantly reducing the symptom severity of OCD and tic disorder for children with PANDAS. Possible mechanisms would be through blocking (via IVIG) or removing (via plasma exchange) the antistreptococcal antibodies that were cross-reacting to the neuronal tissue. Supporting the idea that PANDAS is a separate subgroup of OCD/tic disorder and may require a unique treatment plan.
 
Swedo, Susan E. - https://www.omicsonline.org/from-research-subgroup-to-clinical-syndrome-modifying-the-pandas-criteria-to-describe-pans-pediatric-acute-onset-neuropsychiatric-syndrome-2161-0665.1000113.php?aid=4020
“Establishing a connection between childhood-onset obsessive compulsive disorder (OCD) and preceding infections with Group A streptococcal (GAS) infections was the result of 2 parallel lines of research - longitudinal studies of OCD and a series of investigations of Sydenham chorea (SC) [2-4]. Prospective evaluations of children with OCD revealed that a subgroup had an atypical symptom course, characterized by an unusually abrupt onset (from no symptoms to maximum intensity within 24-48 hours), a relapsing-remitting symptom course, and significant neuropsychiatric comorbidity, including separation anxiety, ADHD-like symptoms and motor tics [1,2]. Often, the (acute-onset) OCD symptoms were preceded by a bacterial or viral infection, such as influenza, varicella and Group A streptococcal (GAS) pharyngitis. The 1st case series suggested the name, 'Pediatric Infection-Triggered Autoimmune Neuropsychiatric Disorders (PITANDS)' to reflect the variety of infectious organisms that had been observed."
Swedo, Susan E. - Documentary: https://www.facebook.com/mykidisnotcrazy/ - https://mykidisnotcrazy.com/ - “My Kid is Not Crazy, a film by Tim Sorel, tracks the journey of 6 children and their families as they become tangled in the nightmare of a medical system heavily influenced by the pharmaceutical industry.”
Sorel, Tim -
My Kid is Not Crazy- documentary - July 19 at 7:22 PM 2018 -
"Here is a behind-the-scenes picture of the 20/20 news magazine interview shot in NYC this past April. I was given the chance to explain why I created the film, what I learned, and in general talk about the frustration of PANS and PANDAS. "
Swedo, Dr. Susan - DSMO - https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2017.pp8b12
8/4/2017 -
 
 

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