P.A.N.D.A.S. By Anne McGoldrick

What is it? “P.A.N.D.A.S.” is an acronym, which stands for “Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.” It is identified clinically after a person develops several behavioral and motor symptoms resulting from a strep infection such as Strep Throat or Scarlet Fever.

What Causes P.A.N.D.A.S? P.A.N.D.A.S. is developed by an autoimmune reaction to a strep infection. The strep molecules are recognized to hide from the host immune system by copying host cells. The immune system recognizes the unfamiliar cells and antibodies, and then the host cells are attacked because of cross-reactivity. Some of the time, the antibodies attack the brain cells, causing the patient to develop OCD symptoms, motor, or vocal tics.

Other Facts The chances of developing one or string these neuropsychiatric disorders are quite rare. Only one in 2,000 children are affected with P.A.N.D.A.S. The first case of P.A.N.D.A.S. was diagnosed in the late 1990s. It was named when a subgroup of children developed sudden cases of OCD symptoms, vocal, and motor tics, separation anxiety, mood changes, changes in handwriting, and sleep disturbances (such as insomnia). Common treatment plans for P.A.N.D.A.S. include Cognitive Behavioral Therapy (CBT), and certain medications. Antibiotics are of good use when trying to actually treat the strep infection. No one has died from PANDAS, most likely because the disorder is not life threatening in any way.

Risk Factors You are at risk of developing P.A.N.D.A.S. if you possess a family history of rheumatic fever; if your mother has a history of having an autoimmune disease, and you are male in the before stages of puberty.

How to Distinguish from other Neurological Disorders Due to the symptoms’ resemblance with other neuropsychiatric disorders, it is often difficult for doctors to distinguish PANDAS from disorders such as Obsessive-Compulsive Disorder (OCD), Tourette’s Syndrome, and other tic disorders. However, it should not be that difficult, for there are also notable differences between any of these. For instance: Tourette’s Syndrome is neurological disorder, which can only be diagnosed as such if the patient demonstrates motor and vocal tics for more than one year continuously. PANDAS, on the other hand, shows symptoms short term, not for long periods of time. Also, for someone to be diagnosed with Tourette’s Syndrome, you must showcase at least two motor tics, and vocal tics within that long period of time. Motor tics can range from shoulder shrugging, snapping, clapping your hands, eye blinking or head nodding. Vocal tics may consist of humming, clearing your throat, or yelling a word or phrase. With PANDAS, you may showcase only one of these tics, or at most two. If you do not demonstrate at least two motor tics, and one vocal tics, these may be classified as a motor tic disorder, or a vocal tic disorder. I’m just going to throw this in here, so people are not mistaken anymore. When I say that a vocal tic may consist of yelling a word or phrase, I do not mean a curse word, or an offensive word. That is, to be exact, coprolailia. Coprolailia actually only affects 10% of those diagnosed with Tourette’s Syndrome, contrary to popular belief, which is, unfortunately, what Tourette’s is known for. Yelling a word or phrase may consist of yelling a sound, such as an “f” sound or a “c” sound.

Bibliography www.medicinenet.com/pandas/articles.htm www.nimh.nih.gov/health/publications/pandas My own brain