What Is PANDAS?
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a pediatric disease with a sudden and dramatic appearance of symptoms of obsessive-compulsive disorder (OCD) and/or tic disorders, or worsening of OCD and/or tics following a strep infection such as strep throat or scarlet fever.
What Are Symptoms of PANDAS?
The main symptoms of PANDAS are obsessions, compulsions, and/or repetitive behaviors and motor and/or vocal tics that come on suddenly, “out of the blue.” Symptoms must be associated with a strep infection.
Additional symptoms of PANDAS may include:
- ADHD symptoms
- Inattention/inability to focus
- Separation anxiety (child has difficulty separating from parents or caregivers)
- Mood changes
- Memory problems
- Sleep problems (insomnia)
- Overnight bed-wetting and/or frequent daytime urination
- Decline in motor skills
- Changes in handwriting
- Joint pains
- Sensitivity to light, touch, and sound
- Loss of appetite
What Causes PANDAS?
PANDAS affects children from age 3 to about 12 years, and rarely, adolescents. It is believed that younger children are more susceptible to PANDAS because they respond to infections with higher quantities of antibodies and a more vigorous autoimmune/inflammatory response than older adolescents and adults. Older adolescents and adults may have a more muted response and thus not exhibit symptoms.
How Is PANDAS Diagnosed?
There are no lab tests used to diagnose PANDAS. It is considered a clinical diagnosis, which means patients must meet certain criteria to be diagnosed with the condition.
The diagnostic criteria are:
- Presence of obsessive-compulsive disorder (OCD), a tic disorder, or both
- Onset of symptoms occurs in pediatric patients age 3 to puberty
- Very sudden onset or worsening of symptoms
- Episodic course of symptom severity
- Symptoms go up and down in severity, usually suddenly
- Symptoms may then slowly and gradually improve
- If another strep infection occurs, symptoms may recur
- Symptoms are associated with group A Beta-hemolytic strep infection, such as a positive throat culture for strep or history of scarlet fever
- Association with neurological abnormalities, such as physical hyperactivity or unusual, jerky movements that are out of the child’s control
A blood test called an anti-strep antibody titer may be performed to confirm a prior strep infection.
What Is the Treatment for PANDAS?
Treatment for PANDAS involves treating the strep infection with antibiotics.
Other treatments for PANDAS include:
What Are Complications of PANDAS?
Complications of PANDAS include:
- Problems at school
- Handwriting problems
- Memory problems
- Recurrences of PANDAS
How Do You Prevent PANDAS?
It may be possible to prevent PANDAS by preventing strep infections.
- Wash hands thoroughly with soap and warm water for 20 seconds
- Use hand sanitizer if soap and water are not available
- Avoid anyone who is sick with strep throat, scarlet fever, sinusitis, impetigo, or other types of strep infections
- Do not share personal items with someone who is sick, such as dishes and utensils, towels, and toothbrushes
- If you are prescribed antibiotics, take the full course prescribed, even if you feel better before the medicine is finished
- Stay home if you feel sick to prevent spreading infection to others
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