PANDAS…not the bears

June 3, 2010 by Evelyn Kashinsky
Posted in•Social Thinking•A Parents View

Every once in awhile as a parent you get knocked for a loop.  Something happens that you don’t understand.

This happened to my youngest child.  I have been overjoyed at my son’s progress.  He has been meeting all his goals; to the point that we thought by the middle of next year no aid would be required.  And then he got sick.  All of a sudden, out of nowhere, my son went into hyper anxiety and OCD mode.  He wouldn’t touch anything. He washed his hand 20 times a day. He changed his clothes as soon as there was a speck of dirt.  He asked if he would die if he touched this or that.  And he cried because he was so afraid.  He stopped eating junk food and refused to play the drums, which was his passion. He also started having ticks that he never had before.
I started calling around wondering (ok panicking) what this could be.  Several people mentioned something called PANDAS.  I looked it up.  The following is taken from the National Institute of Health.  You can access their website at http://intramural.nimh.nih.gov/pdn/web.htm

“PANDAS, is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. The term is used to describe a subset of children who have Obsessive Compulsive Disorder (OCD) and/or tic disorders such as Tourette’s Syndrome, and in whom symptoms worsen following strep infections such as “Strep throat” and Scarlet Fever.

The children usually have dramatic, “overnight” onset of symptoms, including motor or vocal tics, obsessions, and/or compulsions. In addition to these symptoms, children may also become moody, irritable or show concerns about separating from parents or loved ones. This abrupt onset is generally preceded by a Strep throat infection.

What is the mechanism behind this phenomenon? At present, it is unknown but researchers at the NIMH are pursuing a theory that the mechanism is similar to that of Rheumatic Fever, an autoimmune disorder triggered by strep throat infections. In every bacterial infection, the body produces antibodies against the invading bacteria, and the antibodies help eliminate the bacteria from the body. However in Rheumatic Fever, the antibodies mistakenly recognize and “attack” the heart valves, joints, and/or certain parts of the brain. This phenomenon is called “molecular mimicry”, which means that proteins on the cell wall of the strep bacteria are similar in some way to the proteins of the heart valve, joints, or brain. Because the antibodies set off an immune reaction, which damages those tissues, the child with Rheumatic Fever can get heart disease (especially mitral valve regurgitation), arthritis, and/or abnormal movements known as Sydenham’s Chorea or St. Vitus Dance.

In PANDAS, it is believed that something very similar to Sydenham’s Chorea occurs. One part of the brain that is affected in PANDAS is the Basal Ganglia, which is believed to be responsible for movement and behavior. Thus, the antibodies interact with the brain to cause tics and/or OCD, instead of Sydenham Chorea. “

I went to the psychiatrist with my son and explained what happened. He asked if I had ever heard of PANDAS.  I told him I had read about the disorder.  We went for testing and he placed my son on antibiotics.  Within a couple of days the behaviors and the tics started to decrease.  It has been three months and little by little we are regaining the ground we lost.  I want other parents to be aware, that if your child has these symptoms, you should go to a physician who knows about and believes in its existence of PANDAS.  They can then help get the antibiotics that can help with this disorder. Yale University has a specialist who works with this.  As always you can contact us if you need more information.

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