Navigating PANDAS: Understanding Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections

Author: Shanyn Thompson, UF Doctoral Student

Published: January 19, 2024

Navigating the intricacies of pediatric health can be a challenging journey for parents, especially when faced with conditions that are both perplexing and relatively less understood. One such enigma that has surfaced in recent times is Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). As parents, it's natural to be concerned about your children's well-being, and when seemingly unrelated factors like infections intertwine with neurological challenges, the quest for understanding becomes even more crucial. In this blog post, I delve into the defining features, symptoms, and considerations surrounding PANDAS.

 Defining Features of PANDAS:

PANDAS is characterized by the abrupt onset of obsessive-compulsive disorder (OCD), tic disorder (vocal and motor), or a combination of both following Group A Streptococcal infection (commonly known as Strep Throat). This condition typically surfaces in children under the age of 13 and is characterized by marked episodes of increased symptoms.

PANDAS episodes can manifest in various ways, impacting a child's behavior, emotions, and physical well-being. Some of the common symptoms associated with PANDAS episodes include:

·       Obsessive-Compulsive Disorder (OCD): Children may develop unwanted, intrusive thoughts and engage in repetitive behaviors to relieve anxiety associated with these thoughts.

·       Motor Tics: Children may display repetitive movements such as eye-blinking, shoulder shrugs, and head jerking.

·       Vocal Tics: Children may make repetitive sounds including grunting, tongue clicking, and repeating words or phrases spoken by others.

·       Hyperactivity and Impulsivity: Children may exhibit increased ADHD-like symptoms including restlessness, fidgeting, and spontaneous behavior.

·       Anxiety: PANDAS episodes often coincide with heightened anxiety levels, especially anxiety surrounding separation from caregivers.

·       Mood Changes: Emotional shifts, including increased irritability and anger.

·       Trouble Sleeping: Sleep disturbances, such as difficulty falling or staying asleep.

·       Bed-wetting or Frequent Urination: Changes in urinary patterns may be observed.

·       Changes in Motor Skills: PANDAS can affect fine motor skills, leading to alterations in activities like handwriting.

·       Sensory Abnormalities: New sensitivities to sound, light, or textures.

·       Joint Pains: Some children may experience joint pains during PANDAS episodes.

·       Fatigue: Episodes may contribute to increased tiredness, affecting a child's energy levels.

Management and Outcomes:

While PANDAS can present challenges, the good news is that many children often outgrow this condition. Management strategies involve addressing the underlying streptococcal infection and providing appropriate treatment for OCD and tic disorders. Antibiotics may be prescribed to combat the bacterial infection, and behavioral therapies can help manage neuropsychiatric symptoms if they persist.

What Parents Can Do:

·       Document the child’s symptoms: It is important to track PANDAS episodes including episode length, associated symptoms, and symptom severity. Having this information can facilitate communication with healthcare providers, help providers tailor treatment plans, help providers identify triggers, and assist in educational planning.

·       Contact the child’s doctor: Timely recognition of PANDAS symptoms is crucial for effective intervention. Parents and caregivers should maintain open communication with healthcare providers, reporting any sudden changes in their child's behavior or health.

·       Contact the child’s school: Many of the symptoms associated with PANDAS can impact a child’s functioning at school. Maintaining regular and transparent contact with the child’s school can help the teacher establish appropriate expectations for child in the classroom.

·       Contact a licensed psychologist: If the onset of PANDAS symptoms causes your child continued distress, it may be necessary to seek psychological support. FLOAAT offers comprehensive therapy in Gainesville, FL for OCD, anxiety, and ADHD, which are symptoms commonly associated with PANDAS. We would be more than happy to help your child navigate the sudden onset of PANDAS symptoms. Contact us today to get started.

Understanding PANDAS is essential for both medical professionals and parents navigating the challenges posed by this condition. While the sudden onset of OCD or tic disorders after a streptococcal infection can be alarming, early intervention and appropriate treatment contribute to positive outcomes. By recognizing the episodic nature of PANDAS symptoms and addressing them promptly, we can support children in their journey toward overcoming this unique pediatric condition.

Sources:

https://www.nimh.nih.gov/health/publications/pandas

https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/pediatric-autoimmune-neuropsychiatric-disorders-associated-with-streptococcal-infections-pandas/#:~:text=Pediatric%20autoimmune%20neuropsychiatric%20disorders%20associated%20with%20streptococcal%20infections%20(PANDAS)%20is,%E2%80%9D%20bacteria%20(Group%20A%20beta%2D

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