PANDAS: PEDIATRIC AUTOIMMUNE NEUROPSYCHIATRIC
DISORDERS ASSOCIATED WITH STREP
Pandas are kind of like Polar Bears — all cute and cuddly when you see them in Hollywood movies or TV commercials. But when push comes to shove, never forget they’re still bears, and not necessarily the adorable creatures they’ve been made out to be (HERE or HERE). The same is true of another kind of PANDAS — this one known as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Strep.
How common are PANDAS? According to the PANDAS Network, “PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) occurs when strep triggers a misdirected immune response results in inflammation on a child’s brain. In turn, the child quickly begins to exhibit life-changing symptoms such as OCD, anxiety, tics, personality changes, decline in math and handwriting abilities, sensory sensitivities, restrictive eating, and more. PANDAS Network estimates that PANDAS/PANS affects as many as 1 in 200 children.”
The disorder is the result of an over-wound immune system attacking the part of the brain known as the Basal Ganglia instead of confining it’s attack to the strep (experts know this because they consistently find auto-antibodies against the BG).
No matter how you slice it, one in two hundred is a lot of children! Be aware, however, that most doctors are totally unfamiliar with PANDAS, and of those who are, many are deniers and don’t believe it really exists. Take for instance the article from the March 22 issue of UnDark by Katie Rose Quandt (A Rare Disease? Or No Disease at All?). Although the title alone tells the story, suffice it to say that this issue of PANDAS is similar to the way that LEAKY GUT SYNDROME and NON-CELIAC GLUTEN SENSITIVITY used to be — full of medical deniers. That is, until the amount of scientific research became overwhelmingly impossible to ignore.
Two decades ago, a psychiatrist named Susan Swedo, along with a group of a dozen other physicians and researchers, published a study in the American Journal of Psychiatry called Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections: Clinical Description of the First 50 Cases, in which they discussed case reports of children they had been following, some since the late 1980’s.
But according to the pinnacle of truth, Wikipedia, “prospective longitudinal studies have not produced conclusive results.” That is until a few months ago. This summer, JAMA Psychiatry published a study by a team in Denmark (Association of Streptococcal Throat Infection With Mental Disorders Testing Key Aspects of the PANDAS Hypothesis in a Nationwide Study) that looked at incidence of PANDAS following childhood “sore throats”.
In recent years, an increasing body of evidence has pointed toward a critical role of the immune system and infections in the development of mental disorders. However, the PANDAS hypothesis remains controversial, and most prior studies are small and have methodological shortcomings. We investigated the risk of any mental disorders, with particular focus on OCD (obsessive-compulsive disorder) and tic disorders, in children exposed to streptococcal throat infection in the largest population-based cohort study to date, using the nationwide Danish registers.
The study population consisted of all 1,067,743 individuals born in Denmark between 1996 and 2013, and followed for up to 17 years, corresponding to 7.9 million person-years at risk. Persons with a positive streptococcal test result had an 18% higher risk of any mental disorder, a 51% higher risk of OCD, and a 35% higher risk of tic disorders…
Full adjustment did not change the associations. The relative risk of OCD and tic disorders was higher than the risk of any mental disorder. Stratified analyses for the remaining diagnostic codes included in the category of any mental disorder showed that after a positive streptococcal test result, the risk was most elevated for disorders of adult personality and behavior and mood disorders.
Why do I bring this all up? It’s certainly not because I think you need to run out and get more ANTIBIOTICS than most of you are already taking, whether for yourself or your children. Antibiotics destroy GUT HEALTH / MICROBIOME and are themselves heavily linked to AUTOIMMUNITY simply due to the fact that 80% of your immune system lives in the Gut — HERE). By the way, this is not simply my opinion, but the opinion of a physician widely considered one of the leading pediatricians in American history, Dr. Robert Mendelsohn (HERE).
The chief reason I want you to understand today’s post is to better understand that infections have the ability to mess people up in ways that you’ve never heard of before — a topic I’ve written about numerous times in the past (HERE, HERE, HERE, HERE, and HERE, and is likewise true of DYSBIOSIS in general). This certainly makes sense in light of something intimately related to PANDAS knows as PANS. In an article for the International OCD Foundation (What is PANS?), the authors let us know that…..
Newer research has shown that Strep is not the only infection that can cause these sudden-onset symptoms. In a condition known as Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), similar OCD symptoms are observed following an infection, such as mycoplasma, mononucleosis, Lyme disease, and even the H1N1 flu virus.
So the question now becomes, what can be done to reverse, or better yet prevent, PANS or PANDAS? The first thing is to know what to look for. Our own government (the NIH) says of PANDAS, “The symptoms are usually dramatic, happen overnight and out of the blue, and can include motor and/or vocal tics, obsessions, and/or compulsions. In addition to these symptoms, children may also become moody or irritable, experience anxiety attacks, or show concerns about separating from parents or loved ones.”
As far as medical treatment is concerned, Dr. Swedo and others published official government treatment guidelines in a recent issue of the Journal of Childhood and Adolescent Psychopharmacology (HERE).
My best advice is to avoid infections in the first place. And if you do get an infection of some sort (it’s inevitable), not to allow the immune system to get carried away. What do I mean by this? Things that OVER-HYPE THE IMMUNE SYSTEM tend to be the things that cause AUTOIMMUNITY. You want a properly-functioning immune system, not a “Super-Charged” immune system (HERE).
What tends to ramp up immune systems in the age group of children who end up with this problem (80% come down with it by age 10 and the rest by age 13)? How about something that our kids are massively exposed to on a regular basis — ALUMINUM IN THE FORM OF ADJUVANTS (the sole reason it’s in every vaccine you or your kids take is to create inflammation / neuro-inflammation so that the vaccines work “better” by making your immune system work “harder”). MERCURY is also a potential culprit.
And as for infections, never forget that the food of choice for most (the very same thing is true of cancer as well — HERE) just happens to be sugar or high glycemic-index carbs (HERE). And this doesn’t even begin to get into the realm of other forms of toxicity (HERE) or potentially neurologically reactive foods such as GLUTEN. And unfortunately, our children are NOT ONLY USUALLY TOO CLEAN, but are being saturated in this crap, in most cases from the day they are born.
Although I don’t claim to be an expert on PANDAS or PANS, I created a general protocol for helping people return to health that would at least bear looking at. Nope; I didn’t say it was going to be your cure; your panacea; your magic bullet (you will probably not be able to completely avoid medical treatment of some kind with an occult bacterial infection).
However, once you begin to understand the importance of controlling inflammation (thereby toning down the body’s autoimmune responses), THIS PROTOCOL will start to make more sense for any number of problems you or your family may be struggling with. And if you are wondering about PANDAS link to AUTISM, click the link and start reading.