What is PANDAS/PANS + Diagnosis and Treatment


PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep. PANS stands for Pediatric Autoimmune Neuropsyschiatric Disorders. The main differences between the two acronyms are the specificity of acute onset and association with the pathogen strep in PANDAS. The clinical presentation overlaps significantly.

How common is PANDAS/PANS?

According to PANDASnetwork.org, 1 in 200 children experience the clinical symptoms of PANDAS/PANS.

How is it diagnosed? What are the common symptoms?

There are no reliable biomarkers or lab tests to make the diagnosis of PANDAS/PANS. Diagnosis is based on symptom presentation. Clinicians worldwide are working to establish a list of the criteria for the diagnosis. At this time, there is no consensus regarding these criteria. Most practitioners look for common symptoms including the acute onset of neuropsychiatric symptoms.

These symptoms include:

  • Obsessive compulsive behaviors and thoughts
  • Intrusive thoughts or phobias 
  • Tics 
  • Anxiety
  • Personality changes

Behavior changes including sleep disturbances, rage, sudden attachment anxiety, loss of appetite,
involuntary movements and "potty accidents" in a previously trained child. Some children stop talking completely. The severity of these symptoms varies significantly from child to child, and it is rare for a child to have every single symptom associated with PANDAS/PANS.

Are there any objective tests to help with the diagnosis and to track treatment efficacy?

Cultures for strep should be used to assess patients with suspected PANDAS. Checking for antibodies to common infections including viruses and streptococcus can be helpful. Autoimmune markers, including those in the Cunningham Panel from Molecular Labs, are also useful. Labs looking for inflammatory markers can be used to track treatment response.

How is PANDAS/PANS treated in conventional medicine?

Treatment strategies focus on reducing inflammation in the brain and treating the triggering infections. Interventions include both short and long-term antibiotics, IVIG, plasmaphoresis, and steroids. Some psychiatrists also use sedatives, mood stabilizing medications, and anti-psychotic medications to manage symptoms. Once a patient is relatively stable, they may benefit from cognitive-behavioral therapy.

Are there natural treatments that can help a child with PANS/PANDAS?

Absolutely! Herbal medicine can be a very powerful tool for a more safe and effective, long-term antimicrobial approach. Specific herbal protocols are individualized for each patient to most accurately address the microbes out of balance. Functional medicine tools including nutrient therapy can also be very helpful for reducing inflammation and promoting healthy neurotransmitter levels.

How do you treat children with PANDAS/PANS?

In my practice, I look for the underlying cause of the inflammation for each patient. Viruses, vector-borne illnesses, mold exposure, and parasites are all infectious agents that can cause neuropsychiatric symptoms. Detox support and effective reduction of toxic burden is also critical to a successful approach. Correcting nutrient deficiencies can improve the immune response to allow the body to keep the opportunistic infections under control. Additionally, it is important to address the health of each family member to prevent re-exposure from an asymptomatic carrier. Finally, we recognize the significant stress involved in caring for a patient with PANDAS/PANS. It is very important to discuss supportive resources and encourage the caregiver to prioritize their own health in this process. Immune modulation, such as LDI (low dose immunotherapy), is another very successful therapeutic intervention. Treatment protocols using an integrative medicine approach are extremely effective and often result in dramatic improvement in symptoms.

What is Neural Therapy?

Neural therapy is the use of injectable local anesthetics to treat areas of dysfunction at the level of the skin and connective tissue to normalize the autonomic nervous system. Procaine is the most commonly used local anesthetic used in my practice. This particular local anesthetic is metabolized to B-vitamins after it is injected into the connective tissue. It has a short half-life in comparison to other local anesthetics like Novocaine and Lidocaine – the local response of numbness lasts for about 20 minutes. Local anesthetics work by temporarily interrupting the electrical signals of the cells.

Each cell has a normal resting potential. Cells that have an abnormal resting potential (or electrical voltage) do not function optimally. This impacts the cells both individually as well as those distally related by a common network of nerves. This allows us to use neural therapy to help optimize both superficial and deep structures by treating at the level of the connective tissue with very safe, shallow injections. Once the effect of the local anesthetic wears off, the brain signals the tissue to reset at a healthy resting potential. This allows for improved cell-to-cell communication to promote circulation and regeneration of healthy tissues.

Neural therapy is one of the most effective therapeutic interventions I use in my practice to promote healing. I utilize this technique as part of a comprehensive approach to chronic illness and localized pain, as well as to clear areas of dysfunction in the body. Common types of dysfunctional tissue include scars and previous injuries. These injections can provide an amazing degree of pain relief for both chronic and acute conditions. I have been able to help patients with severe back, shoulder, knee, neck, hip, and ankle pain (among many others) by using neural therapy. Additionally, we can inject over areas of organ stress. I use it as part of my comprehensive protocols to treat issues such as chronic constipation, irregular menstruation, frequent or painful urination, sinus pressure, and respiratory irritation.

I learned this technique from my mentor, Dr. Dietrich Klinghardt, MD, PhD. He has published articles on neural therapy in both English and German, and continues to both practice and teach the technique worldwide.

Learn more here.

Disclaimer: All content found on drkatiedahlgren.com is for informational purposes only, and is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any medical questions you may have. Consent has been given for any patient images on this site.