In functional medicine, we see a myriad of patients who have been dismissed by conventional medicine as psychosomatic, meaning “its just in their head”. Many children, teens, and occasionally young adults enter our clinic with the oddest of mental and emotional symptoms. The common factor lies in the symptoms having begun suddenly soon after some type of infection. It seems too crazy to be true. Personality changes, tics (repetitious movements), obsessions, compulsions, panic attacks, anxiety, aggressive behaviors, hallucinations, and more burst in upon the scene of the child’s life after a sore throat or other simple infection.
Parents can’t believe their eyes or ears. They are desperate to get their children back. They visit one doctor after another hoping for answers. Unless they meet a doctor familiar with PANDAS, little answers and little hope are offered except psychiatric meds and therapies. Below are the keys parents need to know to help their children recover from this frightening illness.
Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection (PANDAS) is the classic example of the disease process. However, it is but one example of many different triggers for this illness. For this reason, parents are better off thinking in terms of Pediatric Autoimmune Neuropsychiatric Syndrome or PANS rather than just PANDAS. PANS includes episodes triggered by a number of different possible infections. Strep, Lyme, other bacterial and other viral illnesses are all potential triggers for the child’s body to attack its own nervous system. The child’s immune system misidentifies its own nerve cells as enemy invaders and attacks itself. This attack triggers different odd symptoms as noted above depending on which part of the brain is affected.
While not extremely common as it affects 1 in 200 to 500 children, it is not uncommon either. However, without the willingness of medical providers to admit its existence, it often goes undiagnosed. Even when a provider is willing to consider the diagnosis, no one test exists that is 100% accurate in diagnosing PANS. This is highlighted further when considering that Strep is not the only infection that may trigger this syndrome. Ultimately, a clinical diagnosis is in order. This diagnosis requires meeting certain symptom criteria which include 2 symptoms of the following: anxiety, emotional instability/depression, oppositional behavior like aggression, regressing developmental behavior, worsening of school performance, disabilities in sensory or motor capabilities as well as signs and symptoms like sleep or urinary problems or eating restrictions. (NIMH website) These symptoms must have an abrupt onset after an acute illness to be considered a PANS related illness.
If you are a parent staring at your child in disbelief as they have transformed into someone you don’t recognize behaviorally, ask yourself the following questions:
- Did these behavior changes occur suddenly after an acute illness?
- Do they worsen with another episode of an infectious illness?
- Are other explanations unlikely or ruled out already by medical providers?
If you are answering yes, then find someone who both believes that the diagnosis exists (many still deny it is real) and who can address the variety of triggers that may be underlie this disease. Both the identification of the infection and an understanding of the child’s immune system function is critical. Remember, it is more than just a Strep related issue. Using lab testing to find the source of the infection (i.e. Strep, EBV, Lyme, and others) leads to targeted therapy for this acute problem. These specific therapies go far beyond the grossly expensive general therapy IVIG (intravenous immunoglobulins or antibodies). With a Functional Medicine understanding of how the immune system can be modulated to counteract the frightening symptoms of PANS (or PANDAS), children can be restored back to normal.
Parents need to know that natural anti-microbial (for viral or bacterial triggers) therapies and pharmaceuticals are available. These go beyond a psychiatric med to target the root cause of the problem. Parents need to know that natural therapies exist that can alter the immune dysfunction causing PANS. Parents need to know that their child can be restored.
The impact of this syndrome on a child’s life can be minimized by this two-pronged Functional Medicine approach:
1) Natural and pharmaceutical anti-microbials
2) Immune modulating natural therapies.
Using the intensive Functional Medicine approach at Sanctuary Functional Medicine, we see PANS symptoms and other unexplained syndromes improve over time. Children with PANS or PANDAS can liver a healthier, more abundant life when we take time to both find the root cause and treat it wholistically with the best of natural and conventional medicine.
NIMH Website
Great Educational Resources
PANDAS Network
http://www.pandasnetwork.org/understanding-pandaspans/what-is-pandas/
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.
