PANDAS – OCD and Strep
Pediatric Autoimmune Neuropsychiatric Disorder Associated (PANDAS) is a relatively new disorder that seems to be caused as a response to a strep (streptococcus) infection as a child. There are a few different ways that the symptoms of PANDAS can present themselves and there is still no clearly defined protocol for diagnosis. If there are obsessive compulsive disorder (OCD) or tic symptoms that appear suddenly appear for the first time and the child is under the age of 10 than PANDAS could the cause. This can be especially telling if the symptoms start to present during or just after a strep infection.
How is PANDAS Caused?
PANDAS is caused by the body’s immune response to the infection with strep; not the actual infection itself. When a strep infection happens, the child’s body produces antibodies and these play a factor in the causation of PANDAS, but the exact mechanism is unknown. It has been reported that other immune triggers can worsen the OCD and tics, but there is no scientifically approved evaluation or treatment options available.
Diagnosing PANDAS
Most of the time, children with PANDAS are initially diagnosed with OCD or a tic disorder, as these are the symptoms of the disease. The symptoms also present in the same form as childhood OCD and tic disorders and can be difficult to discern the difference. The typical age range for PANDAS is from age 3 until puberty. In addition to the OCD and/or tics, the children may also have any/all of the following symptoms: sudden unexplainable rages (also called emotional lability), personality changes, ADHD (Attention Deficit Hyperactivity Disorder) that is new or dramatically worse, anorexia (often because of a fear of choking, or fear of throwing-up), age inappropriate behaviors (such as bedtime fears/rituals, loss of impulse control), separation anxiety defensiveness caused from hyperactive senses (such as sensitivity to clothing, noise, light, taste, etc.), noticeable decrease in handwriting or math skills, or frequent urination (especially when the child has an active infection).
The diagnosis of PANDAS should be discussed with a physician after any of these symptoms appear or worsen. The changes also tend to be severe and sudden, often seeing the switch over a week, or even as little as a day. Getting an accurate diagnosis of strep through a throat swab is the best way to determine if these symptoms could lead to PANDAS.
PANDAS can be a difficult disease to watch a child go through and although there aren’t many treatment options yet there is hope for a solution in the future. Getting a proper diagnosis will help to rule out any of the other possible diseases or illnesses and help you to start understanding what you are dealing with.