PANDAS

[Guest guest]

Pessy-

I am surprised too @ this problem/complication not being more

recognized/understood. I think it is probably under-diagnosed personally. I

think our immunologist may be more open to newer theories than some and has seen

that my son has already been treated MANY times with the strongest antibiotics

out there for strep and his other frequent infections that 'cover' strep as

well. I am praying that more doctors are open to treating and recognizing PANDAS

and that all the kids out there who need the help can get it. I would be happy

to participate in any studies or research on this in hopes of helping others.

Lori

lucky mom blessed with triplets

www.caringbridge.org/visit/bradenwild

>

> You know, when I think about how PANDAS happens, the antibodies going nuts

> by basically attacking the basal ganglia in the brain while trying to fight

> off strep bacteria, it is interesting that more immunodeficient kids don't

> get this problem.

>

> Be that as it may, treatment for PANDAS is still very controversial. You

> need to be very lucky to find a doctor to treat it. Majority of them don't

> believe in treating this condition, as debilitating as it is for the person

> suffering it. So I was very interested to hear that IVIG can be used for

> this. Given that your child has immunodeficiencies, I can see this tipping

> the scale in favor of treatment. We have been lucky that our dr. happens to

> be the person to go to for PANDAS in our neighborhood, thus she knew to test

> and treat for it. But, almost all other drs. will give the patients a hard

> time prescribing oral zithromax or augmentin.

>

> Pessy

>

[Guest guest]

Please read below about PANDAS. The medical establishment is stating that the antibioties produced in the body of children with strep infection causes a neurological condition called PANDAS. They admit the antibodies cause brain inflamation which can cause ADHD, tics or Tourettes! My grandson who has severe to moderate autism now has a strep infection and tics so the doctor said he believes the strep is causing them. After reading what the treatment is for PANDAS I am concerned. It is the same Psychotropic poisons they prescribe for many other things. I am angered that they will admit that antibodies cause brain inflamation and many symptoms but won't admit that the antibody response to vaccines does harm. Unbelievable!

C.

Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus, also known as PANDAS, is a condition that can occur within a child with a diagnosis of ADHD, autism, Asperger’s syndrome, obsessive compulsive disorder, or tic disorder (such as Tourettes syndrome).

PANDAS leads to autoimmune-mediated inflammation of the brain, and usually occurs after several bouts of Strep throat, but may manifest even if the parent cannot recall a history of Streptococcal infection in their child.

PANDAS attacks a part of the brain known as the basal ganglia. The basal ganglia links the cerebral cortex (involved in rational, calm behaviour) with the primitive areas of the brain (involved in fear, anger, and uncontrolled emotion). When the basal ganglia is disrupted by the brain inflammation caused by PANDAS, serious changes in behaviour and though processes can occur.

Symptoms and Signs often associated with PANDAS

Tic disorder or obsessive compulsive disorder (OCD)

Onset of symptoms between the ages of 3 and start of puberty

Episodic course of symptom severity (dramatic ups and downs in the child’s behaviour)

Associated with a group A beta hemolytic strep infection (positive throat culture for Strep or history of Scarlet Fever

Neurological abnormalities such as hyperactivity or choreiform movements

*The above diagnostic criteria for PANDAS are specified by the National Institute of Mental Health

ADHD symptoms such as inattention and hyperactivity

Separation anxiety

Mood changes which may include irritability, anger, fear or sadness

Sleep disturbance

Bed wetting or increased urinary frequency during the day

Fine/gross motor changes (Changes in handwriting, unusual or repetitive movements)

Joint pain

Is there a test to see if my child has PANDAS?

There is no test available to definitively diagnose a child with PANDAS. Diagnosis can only be made clinically by the symptoms that the child presents with.

To diagnose a current or recent Streptococcal infection the following tests are available:

A throat swab (rapid Strep test or throat swab culture) can identify a current case of Strep throat

An ASO titre (antistrepolysin titre) shows an elevation in antibodies to Strep 3-6 weeks after infection

An AntiDNAase-B titre (antistreptococcal DNAase B titre) shows an elevation in antibodies to Strep 6-8 weeks after infection

A positive result in any of these tests does not diagnose PANDAS, it just gives more information about whether the child has had a recent exposure to Strep. In addition, low Strep titres do not rule out PANDAS. If symptoms of PANDAS occur suddenly, it is useful to have the above Strep titres tested to see if a recent Strep infection could be related.

Beyond this point, further testing for food allergies/sensitivities, as well as levels of immunoglobulins (IgE, IgG, IgA, and IgM) can be done to assess for additional burden on the immune system that is contributing to the child’s susceptibility to PANDAS.

Treatments for PANDAS

Treatments for PANDAS are not yet well-studied as this condition has only recently been identified. Conventional treatments may include oral antibiotics to eradicate a Streptococcal infection, and prophylactic antibiotics to prevent recurrence. Oral prednisone is also used as a potent anti-inflammatory to relieve inflammation of the brain and prevent damage. Another therapy known as intravenous immunoglobulin (IVIG) is being investigated.

Complementary treatments support the use of antibiotics with probiotics (non-Streptococcal strains), and natural therapies to downregulate inflammation and support the brain, such as curcumin, EPA and DHA. Vitamins and minerals to support immune function (vitamin C, B vitamins, zinc, and selenium) should be administered intravenously. Intravenous glutathione, a potent antioxidant, can be used to protect the brain from being damaged from inflammation.

Investigation should be done to rule out or treat other non-Streptococcal infections that may be present such as Candida (yeast), parasites, viruses (EBV, CMV, HSV), Lyme disease, or pathogenic bacterial overgrowth. Food allergy and food sensitivity testing can be done, and foods should be eliminated from the diet that may be placing additional burden on the child’s immune system.

Lifestyle modifications are also important. Children with recurrent Strep infections may be constantly re-inoculated with the Strep bacteria through an asymptomatic family member. Some people are carriers of Streptococcus, and special care must be taken to prevent spread from carriers to the susceptible child. A child may also be re-exposed to Strep through skin infection (impetigo), urinary tract infection or ear infection. Immune system support to prevent recurrence of these conditions is important in long-term management of PANDAS. The tonsils and adenoids may harbor Streptococcal bacteria and some evidence suggests tonsil and adenoid removal in cases of PANDAS; however, careful consideration of the role of the tonsils and adenoids in fighting infection should be made before making this decision.