It is essential to get a proper diagnosis and treatment when our children are affected by unexplainable conditions. Improper diagnosis can lead to an unsuccessful treatment which might leave your child suffering from the condition. It is proven the most accurate in cases of PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and PANDA (Pediatric Autoimmune Neuropsychiatric Disorder Associated).
Children suffering from PANS and PANDAS are often known to be misdiagnosed. The doctor mistakes their condition for any psychiatric illness and tends to treat them with psychotropic drugs to manage the symptoms they have. PANS and PANDAS being an infection-triggered autoimmune condition doesn’t get treated by these psychotropic medications and treatment. Studies show that the symptoms of PANS and PANDAS have only reduced to a great extent if the patient is treated with required immunological therapy and anti-infective treatment.
Diagnosing PANS and PANDAS is a challenge faced by a lot of doctors as their symptoms can be misleading and could mimic other conditions. Hence, it is recommended by Washington DC Children’s Neurologist, Dr. Beth Latimer that you find an experienced and renowned neurologist for your child. Here is every information you need about these conditions.
What are PANS and PANDAS?
PANS that is also known as Pediatric Acute-onset Neuropsychiatric Syndrome is a clinical diagnosis or a clinically defined disorder, that is given to children who show symptoms as a sudden onset of neuropsychiatric symptoms like OCD(Obsessive-Compulsive Disorder) and restrictions in eating. It is accompanied by acute behavioral deterioration along with motor or sensory changes in some children.
PANS is caused due to various triggers such as environmental or infectious triggers or metabolic disturbances which misdirects the immune response results. It leads to an inflammation of the child’s brain.
The child starts showing some sever, life-changing symptoms that include:
- Eating restrictions.
- The difficulty with school work or Attention Deficit.
- Personality changes.
- Emotional balance.
- Urinary frequencies.
- Cognitive decline.
Along with these symptoms, in some cases, doctors have found the presence of neurological problems like mental impairments, vocal or motor tics, thought disorders, increase in sensory sensitivity, enuresis, and deterioration in writing skills. Disturbance in sleep patterns is also observed. The only subset of PANS known to date is PANDAS.
PANDAS: First reported in 1998 by a team of National Institute of Mental Health. It is not yet validated as a disease and is known to be a subset of PANS. PANDAS is also known as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. The patients of PANDA have shown two to three days of acute onset of neuropsychiatric symptoms that include tics and OCD as seen in PANS.
The diagnosis of PANDAS is performed in five main categories:
- Sudden OCD overnight.
- Disabling and dramatic tics
- An episodic, relapsing and remitting course of symptoms.
- Onset at a very young age( Mostly 6-7 years)
- Presence of some of the neurological abnormalities
- Group A Strep (GAS) infection and the onset of symptoms with the temporal association.
Along with these symptoms the patients are also seen to have symptoms of PANS. The patients suffering from PANDAS also test positive for scarlet fever, perianal strep or strep throat.
Understanding the difference between the both conditions
It is essential to realize that both the conditions are different and are also diagnosed by entirely different criteria. Unlike PANDAS, PANS is known to focus on the clinical symptoms rather than the etiological factors.
PANDAS occur when the sudden onset of tics and OCD along with the other mentioned symptoms are connected to a specifical strep.
PANS, on the other hand, is known to be triggered by not just strep but also other infectious agents along with some non-infectious triggers such as environmental factors and metabolic disorders.
Treatment for PANS and PANDAS
NIMH hasn’t yet offered a proper and efficient treatment plan for this syndrome. Although an attempt can be made to treat it as PANDAS is treated. In case of PANS, The onset of symptoms usually corresponds to an infection, so if they are treated with appropriate antibiotics, they can show moderate to good results but may still require further interventions. In patients who do not show improvement after the course, the course can be extended from a few months to a year.
However, the treatment for PANDAS includes the same treatment that is given in case of OCD and TS. They include:
- Cognitive behavioral therapy.
- Drugs such as Selective Serotonin Reuptake Inhibitors.
- Conventional Therapy for Tics.
The prognosis has been excellent in children who have been diagnosed and treated early. Some patients can even respond shortly and can get completely healthy. So if you find your child suffering from any of these symptoms, contact your neurologist today!