PANDAS: what is it?
PANDAS disease is a short form for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. Usually affects children before age 12 and rare after that for some unknown reasons. It appears after a sore throat/ usually a streptococcal infection. Associated with abrupt onset of Obsessive compulsive symptoms, tics which peak or reach severity within a couple of days. Also associated symptoms include: Separation anxiety, bedwetting, trouble with concentration-ADD, irritable/anger, inappropriate laugh or baby talk, indicating some regression in the child’s behavior and development.
What causes it: As noted above usually it occurs after an infection mostly a streptococcal one, though occasional cases following other viral infection, Lyme disease etc.-which cause a strong immune reaction in the child’s body. The antibodies which normally develop after an infection at times starts reacting to the ones own body cells, mostly on heart muscle and basal ganglion in the brain, or what is also called an autoimmune reaction.
How to Diagnose: When the OCD and Tics start suddenly after an infection, seek an immediate visit/ appointment with a pediatrician, who will request lab tests such as throat swab for a quick diagnosis, culture, ASO titer
,( more useful when the titer increases after a month or so), an MRI of the brain to rule out other intracranial lesions, EEG, at times a LP to rule out other infections.
Treatment: Usually a symptomatic treatment along with treating the infection with antibiotics, treating the OCD and Tics with SSRIs and cognitive Behavioral Therapy. Also a prophylactic antibiotic treatment with Penicillin to prevent future occurrences of strep infections.