PANDAS is a term used to refer to Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep. It is believed to be an autoimmune disorder that is triggered by a Streptococcal infection, typically in the form of strep throat. Symptoms that resemble those in obsessive compulsive disorder or OCD in children appear or made worse during or shortly after this infection.
When an infection occurs, the body releases natural antibodies to fight the infection. With this condition, these antibodies will begin to attack the body and its systems, especially certain parts of the brain that cause PANDAS symptoms. This is a pediatric disorder, with the first onset occurring before puberty.
Symptoms of PANDAS are similar to those of OCD in children. The child may have anxiety, irrational fears or phobias, intrusive thoughts, and repetitive behaviors. Other mental symptoms include some of the following: regressions in behavior, such as separation anxiety, trouble sleeping, and difficulty in concentrating. Some of the physical symptoms include tics, enlarged pupils, problems with fine motor skills, such as with handwriting, increased urination, and even some problems affecting short term memory.
PANDAS symptoms will have a rapid onset that occurs close to the time of a strep infection. Symptoms of PANDAS will vary over time, sometimes getting worse and other times improving, until the infection if completed cured. The body cannot fight this infection itself, so a doctor must be consulted so the child can be treated with the proper antibiotics.
There is no diagnostic test for PANDAS. However, there are tests to detect the presence of strep bacteria, which can help the doctor make an accurate diagnosis. It is important to differentiate between PANDAS and typical OCD. OCD will remain steady over time, while PANDAS has a rapid onset that will come and go until the infection is eradicated. However, the symptoms will gradually begin to improve once antibiotic treatment is started.
Often the symptoms of OCD will persist even after the infection has been completed treated. In those cases, children can benefit by the use of traditional OCD therapy which may include the use of counseling and certain medications. In severe cases, patients may need to have a plasma exchange to remove remaining antibodies from the blood. This will be performed in the hospital, but occurs rarely.