Re: PANDAS FAQ

[Guest guest]

There's a PANDAS support group and the members have collectively written this:

http://www.latitudes.org/forums/index.php?showtopic=6265

and a flow chart about treatments

http://www.latitudes.org/forums/index.php?showtopic=6688

Here's an excerpt from the FAQ

Children with PANDAS must be initially diagnosed with Obsessive Compulsive

disorder or a tic disorder [swedo2004]. These children may have some of the

following symptoms that accompany the OCD or tic disorder

[swedo1998][Moretti2006]:

* Obsessions (e.g., preoccupation with a fixed idea or an unwanted feeling,

often accompanied by symptoms of anxiety)

* Compulsions (e.g., an irresistible impulse to act, regardless of the

rationality of the motivation)

* Choreiform movements (e.g., milk-maid grip, fine finger playing movements

in stressed stance)

* Emotional lability (e.g.,irritability, sudden unexplainable rages, fight

or flight behaviors) (66%)

* Personality changes (54%)

* Age inappropriate behaviors particularly regressive bedtime fears/rituals

(50%)

* Separation anxiety (46%)

* Oppositional defiant disorder (40%)

* Tactile/sensory defensiveness (40%)

* Hyperactivity, impulsivity, fidgetiness, or inability to focus (40%)

* Major Depression (36%)

* Marked deterioration in handwriting or math skills. (26%)

* Daytime urinary frequency/enuresis (12%)

* Anorexia (particularly fear of choking, being poisoned, contamination

fears, fear of throwing up)

PANDAS/OCD is a clinical diagnosis, often marked by the sudden onset and extreme

symptom exacerbations (such as an increase of +18 points on the OCD CY-BOCS

score during an exacerbation [2004]). The abrupt onset and remission after

eradication of streptococcal infection separates the child from non-PANDAS

OCD[swedo2004]. Many parents can pinpoint a day or a week when behaviors changed

[ & #1047;engel-K & #1100;lt & #1100;r2009]

When a child has primarily vocal and motor tics, the symptoms may appear to

overlap with symptoms of Tourettes Syndrome; however, the children can be

differentiated by observing symptom exacerbations over time [Pavone2006]. In

PANDAS children, a streptococcal infection precedes symptom exacerbation and

once treated, initial exacerbations generally remit. The rapid onset with

significant remission is characteristic of PANDAS.

Researchers have described chronic PANDAS [Pavone2006] where the tics and/or

obsessive-compulsive disorder have a much more gradual course. These cases are

difficult to separate from non-PANDAS tics or OCD. Some researchers have found

other immunologic markers (anti-neuronal and anti-basal-ganglia antibodies) that

help separate PANDAS and non-PANDAS children[Kirvan2006].

As for a cure, most parents prefer to work for remission. But there are several

young adults who had this as kids or in the teen years who are now describing

themselves as cured.

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Lastly can it be cured?

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