A Neurological Storm

Children with autism often face complex medical challenges beyond their developmental and behavioral symptoms. One such condition, PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) or PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections), can significantly exacerbate the difficulties these children experience. These syndromes involve the immune system attacking the brain, leading to dramatic changes in behavior, mood, and motor control. Let’s explore what PANS/PANDAS is, how it impacts children with autism, and what steps can be taken to address it.

What Are PANS and PANDAS?

  • PANS is a clinical diagnosis describing acute-onset obsessive-compulsive symptoms or eating restrictions accompanied by at least two additional symptoms, such as anxiety, mood swings, or motor abnormalities.
  • PANDAS, a subset of PANS, is specifically triggered by streptococcal infections, like strep throat.

Both conditions are rooted in autoimmune dysfunction. When the body encounters a trigger, the immune system mistakenly attacks healthy brain tissue, especially in areas like the basal ganglia, which regulate motor control, emotions, and behavior.

How Does PANS/PANDAS Affect Children with Autism?

Children with autism may already have immune dysregulation and neurological sensitivities, making them more vulnerable to the effects of PANS/PANDAS. The overlap of symptoms can sometimes delay diagnosis, but the acute onset of new behaviors is a hallmark of these conditions.

Key Symptoms:

  1. Obsessive-Compulsive Behavior: Sudden and intense rituals or fixations.
  2. Severe Anxiety: Often irrational and overwhelming fears or phobias.
  3. Mood Dysregulation: Irritability, emotional outbursts, or depression.
  4. Motor Tics or Abnormal Movements: Sudden onset of involuntary movements.
  5. Regression: Loss of previously acquired skills, such as speech or motor abilities.
  6. Tourette syndrome (TS): A neurological disorder that causes a person to have repeated, sudden, and involuntary tics, either vocal sounds or muscle jerks.

The Neurological Impact

PANS/PANDAS can disrupt communication within the brain. Inflammation caused by the immune attack leads to:

  • Basal Ganglia Dysfunction: Resulting in tics, OCD, and movement abnormalities.
  • Cognitive Decline: Difficulty concentrating, memory issues, and executive function challenges.
  • Behavioral Changes: The child may exhibit aggression, clinginess, or isolation.

These neurological effects can amplify the challenges of autism, making early intervention critical but and also be life threatening.

Steps for Addressing PANS/PANDAS

  1. Diagnosis: Work with a specialist (in functional medicine) familiar with PANS/PANDAS. Blood tests may reveal markers of inflammation or infections like strep.
  2. Treatment of Underlying Infections: Antibiotics or antivirals may be necessary to address bacterial or viral triggers.
  3. Anti-Inflammatory Therapies: Steroids or non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce brain inflammation.
  4. Immunotherapy: Intravenous immunoglobulin (IVIG) or plasmapheresis may be considered in severe cases.
  5. High-Dose Vitamin C: This potent antioxidant can help reduce oxidative stress and inflammation in the body.
  6. IV Ozone Therapy: Ozone therapy can support immune modulation and improve oxygen utilization in the body, promoting healing.
  7. Holistic Approaches: Addressing gut health, nutritional deficiencies, and overall immune support can complement traditional treatments.

Initial Diagnostic Work-Up for the Child

  • If you suspect your child has PANDAS or PANS, the following labs, in addition to completing the symptom scales, can help aid your medical provider in making a proper diagnosis. A printable PDF of basic blood work can be found here.
  • Recent 2024 immunological research may be helpful when discussing your child’s symptoms with your doctor.

Basic Blood Work

  • IgA
  • IgM
  • IgG (subclass 1, 2, 3, 4)
  • CBC
  • ANA
  • Ferritin (iron)
  • B-12
  • Vitamin D

Viral/Bacterial Testing:

  • Strep throat culture, 48-hour culture or perianal culture
  • Antistreptolysin O (ASO), group A strep
  • Anti DNase B
  • Streptozyme
  • Mycoplasma Pneumoniae IgA & IgM
  • Pneumococcal Antibody Titers
  • Lyme disease and co-infections
  • Epstein Barr Virus Panel
  • Coxsackie A & B Titers
  • HHV-6 Titers

Additional Testing:

A Message of Hope

For families navigating autism, the onset of PANS/PANDAS can feel overwhelming. However, with proper diagnosis and treatment, many children experience significant improvements. Recognizing the signs early and seeking specialized care can make all the difference in reducing neurological damage and restoring quality of life.

If you suspect your child may be affected by PANS/PANDAS, you are not alone. Connect with resources like the PANDAS Network and medical professionals to guide your journey toward healing and understanding. Together, we can bring hope and healing to these neurological storms.

A Personal Note

My son suffered from PANDAS for many years, and it took an immense amount of time and effort to find the right treatment for him to improve. We tried multiple treatments for Noah but the PANDAS kept coming back. I recommend annual monitoring of bloodwork. I share this to offer hope and encouragement to those navigating a similar path because you are not alone in this fight. If you have any questions, please feel free to contact me at tracy@autismhealth.com.