PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus) is characterized by an acute onset of obsessions and compulsions and/or tics following a Group A Streptococcal (GAS) infection. Other symptoms may follow, including, for example: restricted eating, separation anxiety, general anxiety, sleep disorders, personality changes, severe mood swings, irritability, ADHD-type behaviors, dysgraphia, loss of math skills, urinary frequency and incontinence, explosive rage, extreme impulsivity, and suicidal ideation. All symptoms invariably wax and wane.

In extreme cases, all facets of daily life can be affected such that some patients may become unable to speak, eat, or even dress themselves; these patients may not be able to attend school and may need to be hospitalized. It is a disorder that affects the entire family.

PANDAS is part of a broader category of disorders called PANS (Pediatric Acute Onset Neuropsychiatric Syndrome) which present in much the same manner, but for which the trigger may not be known.

Aside from strep, triggers could be bacteria such as Borrelia burgdorferi (Lyme disease), Bartonella, and Mycoplasma pneumoniae (walking pneumonia) or viruses such as herpes simplex and even the common cold.

In some people, after repeated infections, the antibodies produced by the immune system appear to go rogue; they cross the blood-brain barrier and target neurons in the basal ganglia part of the brain, likely causing inflammation and consequent neuropsychiatric symptoms.

Both PANDAS and PANS are more likely to occur in childhood but can and do occur in adolescence and, as was the case with Alex, in adulthood. Why some people are so adversely affected by common diseases such as strep is not fully understood.

For more information about PANDAS/PANS, please visit PandasNetwork.Org