Pans/pandas: awareness, causes and treatments

Introduction

Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) are emerging areas of concern in pediatric health. These conditions are characterized by sudden and severe onset of psychiatric symptoms, including obsessive-compulsive behaviors, anxiety, and tics. Raising awareness about PANS/PANDAS is crucial for early diagnosis and effective management. This blog will explore the nature of these disorders, their potential causes, treatment options, the impact of COVID-19, and strategies to help children adhere to an autoimmune paleo diet from a functional medicine perspective.

What Are PANS and PANDAS?

PANS is a broad term describing acute onset of neuropsychiatric symptoms, including OCD, anxiety, mood swings, and regression in motor or academic skills. It can be triggered by various infections, environmental factors, or metabolic disturbances.

PANDAS is a subset of PANS specifically linked to streptococcal infections. The hallmark of PANDAS is a dramatic and sudden onset of symptoms following a strep throat infection.

Possible Causes

From a functional medicine perspective, PANS and PANDAS are viewed through a holistic lens, considering various underlying factors:

1. Infections: Besides streptococcal bacteria, other infections such as mycoplasma, Lyme disease, and viral infections can trigger PANS.

2. Immune Dysfunction: Abnormal immune responses leading to brain inflammation are central to PANS/PANDAS. Autoimmunity, where the body attacks its own tissues, is a key component.

3. Environmental Toxins: Exposure to heavy metals, mold, and other environmental toxins can exacerbate symptoms by weakening the immune system.

4. Gut Health: Dysbiosis, or an imbalance in gut bacteria, can influence brain health through the gut-brain axis. This connection highlights the importance of diet and probiotics in managing symptoms.

Treatment Approaches

Functional medicine emphasizes individualized treatment plans focusing on the root cause of symptoms:

1. Antibiotics: For PANDAS, antibiotics can be effective in treating the underlying strep infection and reducing symptoms.

2. Immunomodulatory Therapies: Treatments like intravenous immunoglobulin (IVIG) and plasmapheresis can help modulate the immune response and reduce inflammation.

3. Anti-inflammatory Diets: Diets like the autoimmune paleo (AIP) diet can reduce systemic inflammation by eliminating potential food triggers.

4. Supplements: Omega-3 fatty acids, probiotics, and vitamins D and B12 support immune function and brain health.

5. Behavioral Therapies: Cognitive-behavioral therapy (CBT) and other behavioral interventions can help manage OCD and anxiety symptoms.

The Relation to COVID-19

COVID-19 has introduced new complexities in the understanding of PANS/PANDAS. The virus can act as a trigger for PANS-like symptoms in children, leading to the term "PANS-COVID." Post-viral syndromes and long COVID have shown that viral infections can have prolonged effects on the immune system and brain health, emphasizing the need for vigilance and early intervention.

Encouraging Compliance with the Autoimmune Paleo Diet

One of the challenges in managing PANS/PANDAS is dietary compliance, especially with children. Here are some strategies:

1. Education: Teach children and their families about the benefits of the AIP diet in simple terms, emphasizing how it can help them feel better.

2. Involvement: Involve children in meal planning and preparation. Allowing them to choose recipes and help in the kitchen can increase their willingness to try new foods.

3. Creativity: Make meals fun and visually appealing. Use cookie cutters for vegetables or create colorful plates to make healthy food more enticing.

4. Gradual Transition: Introduce changes gradually to avoid overwhelming the child. Start by eliminating one food group at a time rather than overhauling the entire diet overnight.

5. Support: Create a support system involving family members, teachers, and healthcare providers to encourage and reinforce dietary changes.

6. Positive Reinforcement: Praise and reward compliance with the diet. Use a reward system to celebrate small victories, making the child feel accomplished and motivated.

Conclusion

Awareness of PANS/PANDAS is crucial for early diagnosis and effective treatment. By understanding the potential causes and exploring a range of treatment options from a functional medicine perspective, we can better support children suffering from these debilitating conditions, as well as the mothers who are caring for them. The impact of COVID-19 has further highlighted the importance of immune health and vigilance. Encouraging dietary compliance, particularly with the autoimmune paleo diet, can play a significant role in managing symptoms and improving quality of life for affected children. Together, with education, support, and holistic care, we can make a difference in the lives of children with PANS/PANDAS.