PANDAS/PANS-Can You See It With Autism?

PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associates with Strep) and PANS (Pediatric Acute Onset Neuropsychiatric Syndrome) occur when the immune system abnormally attacks the brain leading to the abrupt onset of neuropsychiatric symptoms such as motor tics, sensory disturbances, poor handwriting, OCD, and bedwetting.

It can be seen with or without Autism, but our children’s immune systems are more vulnerable and susceptible to infections and autoimmunity like we see with these conditions.

With many kids with ASD, when they run a fever from an infection, their ASD symptoms often improve.

In PANDAS or PANS, the opposite happens- often deterioration of the child.

With PANDAS, it’s a strep infection that induces this onslaught.

With PANS, it is caused by anything else besides strep including viruses, bacteria, yeast, mold, parasites, toxins and allergies.

What usually helps cinch the diagnosis is the abrupt onset of symptoms without any other explanation.

Traditional lab testing will often come back normal.

Strep antibodies can be elevated with PANDAS.

A Cunningham panel can be performed to look for antibodies against the brain.

Treating PANS/PANDAS typically involves a 3-pronged approach: treating the root cause such as Strep in PANDAS with antibiotics, treating the inflammation either with either traditional or natural anti-inflammatories, and addressing the psychiatric symptoms.

If treating the underlying cause is ineffective, some kids may require more invasive therapy with Intravenous Immunoglobulin (IVIG), Plasmapharesis, immune modulating medication, or a tonsillectomy to reset the immune system that has been dysregulated by the underlying cause.

Remember, if you’re seeing an abrupt change in neuropsychiatric symptoms in your child, think PANS/PANDAS and see your practitioner.