logo

CONTACT US

4144 N 44th Street Suite 7 Phoenix, Arizona 85018
Office Hours: M-F 9:00 a.m. – 5:00 p.m.
Mail: patientservices@aznaturalhealth.com

Call: +1 (480) 456.0402




PANS/PANDAS

What is PANS/PANDAS?

PANS(1) (formerly PANDAS(2)) is an acronym for Pediatric Acute-onset Neuropsychiatric Syndrome. This diagnosis is still controversial, yet is gaining support due to many publications illustrating a link between acute/febrile illnesses and an abrupt onset of obsessive-compulsive disorder (OCD), tics, and neuropsychiatric symptoms. The neuropsychiatric symptoms may include: anxiety, emotional lability and/or depression, irritability, aggression and/or severely oppositional behaviors, behavioral regression, deterioration in school performance, and other signs and symptoms, including sleep disturbances, bed wetting or urinary frequency. A diagnosis of PANS is made when the symptoms cannot be better explained by known disorders such as Sydenham’s chorea or Tourette’s syndrome. 

The former acronym, PANDAS, referenced a subset of PANS patients with an abrupt onset of OCD and tics following a streptococcal bacterial infection; it was considered to be autoimmune(3) in nature. The PANDAS autoimmune process begins when the child’s immune system attacks its own brain tissue suddenly and dramatically after a strep throat infection or scarlet fever (i.e. strep throat with a red, rough, fine sandpaper-like rash)(4,5). , The diagnosis has since been expanded to PANS to include a broader range of infectious triggers, as well as non-infectious etiologies if the criteria are met for “abrupt onset.”(1)

Learn more about PANDAS at http://pandasnetwork.org/.

Symptoms that may be associated with PANS/PANDAS that begin after an acute infection:

  • Urinary incontinence, urgency and increased frequency (daytime or nighttime)
  • Mood fluctuations
  • Changes in handwriting
  • Personality changes
  • Oppositional Defiant Disorder
  • Deterioration in math skills
  • Separation anxiety
  • Depression
  • Rages
  • Anorexia

Homeopathic Treatment

Homeopathy is an incredibly safe and effective treatment used by the physicians at Arizona Natural Health Center for the treatment of PANS/PANDAS, without harmful side effects.

Homeopathic medicines are made from natural substances and are prepared so that they are entirely non-toxic. In the United States, the Food and Drug Administration, or FDA, regulates the manufacture and sale of homeopathic medicines. Homeopathy improves health by gently promoting the body’s innate capacity to heal and restore balance.

There are several benefits to this type of treatment for children with PANS/PANDAS:

  • Homeopathic remedies are easy to take and taste good, so most children like them, even very finicky eaters.
  • Homeopathy tends to help the most with tics, OCD behaviors, sensory processing problems, tantrums, violent behaviors, hyperactivity, ADD/ADHD, mood fluctuations, and separation anxiety.
  • Because homeopathy is a holistic therapy, when we treat children with PANS/PANDAS, we are also treating the whole body. If the child also suffers from other problems such as chronic recurrent ear infectionsallergies, digestive problems, or other health concerns, these issues too may be helped by comprehensive homeopathic treatment.

Read this article by Dr. Oskin with a case series of PANS/PANDAS cases treated safely and effectively with homeopathy.

Testimonial

After exhausting a long list of allopathic, naturopathic, and integrative treatments for my child’s complex medical diagnosis – including PANDAS/PANS, developmental delay and multiple other labels, I skeptically resorted to Dr Oskin and started classical homeopathy! While all the other therapies did help somewhat, the gains achieved from a simple, easy to administer remedy have been astounding and long lasting! My child’s mood and anxiety started to improve almost immediately and month after month I continue to see steady gains in multiple different body systems and have been able to discontinue several prescribed medications. A sense of calm has returned to our home. I’m only sorry homeopathy was LAST on my list of things to try instead of FIRST! Dr Oskin is very caring and has a passion for his field. You won’t regret this safe and proven method of treatment! ~ Kate (a very satisfied mom)

Diagnosis and Evaluation

The PANS/PANDAS diagnosis is currently made through a combination of clinical history and laboratory blood tests. Some standard laboratory blood tests may be helpful if the child’s clinical history indicates sudden and drastic onset of tics and/or OCD symptoms after a strep-throat or other infection. If the tics and OCD behaviors start during an acute case of sore throat, the child should receive a rapid strep test and throat culture to rule out an acute strep infection. A strep infection should be treated appropriately. If the acute infection has resolved but the tics and OCD behaviors persist, then it can be helpful to run labs testing for immune markers to see if a recent streptococcus infection may be related to the timing of the onset of PANDAS symptoms. Consult with your physician about ordering these antibody lab tests if you think your child may suffer from PANDAS.(6 – 8)

Conventional Treatment

PANS/PANDAS is still a relatively newly described disorder that has not been universally accepted by the conventional medical community. Current treatments for PANS include long-term prophylactic antibiotics(9), short-term corticosteroids(10,11), intravenous immunoglobulin (IVIG) and plasmaphoresis(12,13), selective serotonin reuptake inhibitors (SSRI’s)(14), and cognitive behavioral therapy(15). Alternative and naturopathic physicians treating PANS have proposed adding treatments such as curcumin(16), food allergy elimination, treating yeast and gastrointestinal infections, and additional immunosupportive treatments(17). This is an area of ongoing research and the use of some of these medications is currently considered off-label and experimental.(18-20)

References:

1. Swedo SE, Leckman JF, Rose NR. From Research Subgroup to Clinical Syndrome: Modifying the PANDAS Criteria to Describe PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). Pediatr Therapeut. 2012;2(2):113.

2. Swedo SE, Leonard HL, Garvey M, et al. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry. 1998;155(2):264-271.

3. Pavone P, Bianchini R, Parano E, et al. Anti-brain antibodies in PANDAS versus uncomplicated streptococcal infection. Pediatr Neurol. 2004;30(2):107-110.

9. Snider LA, Lougee L, Slattery M, Grant P, Swedo SE. Antibiotics prophylaxis with azithromycin or penicillin for childhood-onset neuropsychiatric disorders. Biol Psychiatry. 2005;57(7):788-792.

10. Kondo K, Kabasawa T. Improvement in Gilles de la Tourette syndrome after corticosteroid therapy. Ann Neurol 1978;4:387.

11. Matarazzo EB. Tourette’s syndrome treated with ACTH and prednisone: Report of two cases. J Child Adolesc Psychopharmacol 1992;2:215-26.

12. Perlmutter SJ, Leitman SF, Garvey MA, et al. Therapeutic plasma exchange and intravenous immunoglobulin for obsessive-compulsive disorder and tic disorders in childhood. Lancet. 1999;354(9185):1153-1158.

13. Garvey MA, Snider LA, Leitman SF, Werden R, Swedo SE. Treatment of Sydenham’s chorea with intravenous immunoglobulin, plasma exchange, or prednisone. J Child Neurol. 2005;20(5):424-42

14. Pigott TA, Seay SM: A review of the efficacy of selective serotonin reuptake inhibitors in obsessive-compulsive disorder. JClin Psychiatry 1999, 60:101-6. 82. Biondi M, Picardi A: Increased

15. Storch EA, Murphy TK, Geffken GR, et al. Cognitivebehavioral therapy for PANDAS-related obsessive compulsive disorder: findings from a preliminary waitlist controlled open trial. J Am Acad Child Adolesc Psychiatry. 2006;45(10):1171-1178.

16. Aggarwal BB, Harikumar KB. Potential therapeutic effects of curcumin, the anti-inflammatory agent, against eurodegenerative, cardiovascular, pulmonary, metabolic, autoimmune and neoplastic diseases. Int J Biochem Cell Biol. 2009;41(1):40-59.

17. Rondeau, Steve. PANDAS: An Immune-Mediated Mental Illness. NDNR. December 2010: Vol 6, Issue 12, pp. 1-4.