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According to PANDAS Network, one in 200 children in the United States may have PANDAS Syndrome. You may be like many, wondering, what is PANDAS? Is it a good thing or a bad thing? If it’s bad, how do I protect my child from getting it?

These are great questions, all of which are addressed below.

PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. Yep, you read that correctly. It has something to do with the dreaded strep throat, that so many children acquire every year.

The more you know about strep can help you better understand PANDAS.


What is Streptococcal Infection?

When talking about “strep throat,” doctors usually talk about Group A Streptococcal infection or GAS. If you have GAS, you have been infected with spherical bacteria that can spread from one human to another.

If left untreated, GAS can lead to other dangers, like rheumatic fever, skin infections, impetigo, kidney damage, and PANDAS.


PANDAS History

In the 1990s, researchers studied children who exhibited a sudden onset of obsessive-compulsive disorder symptoms, tics, and other behavior changes. A common denominator among the children was that they all had a streptococcal infection.

Some of the kids also had bacterial infections related to Lyme disease. However, strep was the only infection held by all of the children.

When the kids acquired strep, their bodies had an autoimmune reaction that produced severe inflammation. The autoimmune response attacked both good and bad cells inside the child’s body. Some of the functional cells attacked were brain cells, causing tics and other behavioral changes.


Symptoms of PANDAS

Children who develop PANDAS do not all have the same symptoms. This is one reason it is crucial to seek help from a specialist in autoimmune diseases as soon as you notice symptoms.

Obsessive-compulsive disorder, attention deficit disorder, motor tics, and verbal tics are common. But if you notice symptoms like high separation anxiety, bed-wetting, sleep disorders, or changes in their usual mood, it’s best to have it checked out.

Some parents have reported a change in their child’s handwriting as a symptom of PANDAS. To be safe, if it is unusual behavior and it has appeared rather suddenly for your child, seek treatment.


Where to Seek Treatment

As mentioned before, doctors who specialize in autoimmune disorders are the ones who can best recognize and diagnose PANDAS. Most people start their journey at their family physician’s office. The doctor treats strep with an antibiotic and instructs to return if they continue to have symptoms. The problem with this is that the symptoms change. Your child may not have strep throat anymore, but have developed behavioral changes.

It’s at this point that most parents make an appointment with a psychiatrist or behavioral therapist. They go to counseling or put their child on medication. Both can work in the short-term, but they are not the solution for PANDAS. Symptoms will continue.

The best way to help your child is to make an appointment with a doctor who uses the five major criteria referenced in PANDAS:

  1. Presence of symptoms that mimic OCD, ADHD, tics, or oppositional behaviors.
  2. The onset of symptoms was sudden and varied in intensity.
  3. Neuropsychiatric symptoms like temper tantrums, anxiety, regressive behaviors like bed-wetting or sucking the thumb, or deterioration in specific skills like math or handwriting.
  4. Age of onset ranges between three and puberty.
  5. Positive test at any time in their past for streptococcal infection.

Because all of these may not occur simultaneously, parents need to keep detailed records of their child’s behaviors. Include day, time of day, environment, symptoms, etc. Videotaping can also help in showing your doctor the behaviors exhibited.


Treatment of PANDAS Syndrome

Once your child is diagnosed with PANDAS, your doctor will develop a treatment plan. Most doctors will prescribe antibiotics to treat strep infection. This is necessary. However, this should not be the only treatment.

Seek a second opinion from a Lyme literate doctor since they are hyper-focused on treating autoimmune disorders.

To give your child the best chance of complete recovery, your doctor should have a PANDAS treatment protocol they follow. They should also have the equipment in their office to provide the treatments.

Below are essential steps in a PANDAS Syndrome treatment protocol:

      • Immunotherapy with plasmapheresis is a treatment that eliminates immune hindering culprits that cause inflammation. Doctors should also provide treatments that improve immune responses, like immunoglobulin therapy.
      • Treating any co-infections like Bartonella or Babesia, as well as strep, is vital. Your doctor will want to make sure no harmful bacteria remain in your system that can regrow and redevelop, causing symptoms to return. Some doctors can treat PANDAS with regenerative stem cell therapies.
      • The basis for all PANDAS treatments should involve eliminating inflammation, which can create pain throughout the body and a host of other ailments. Also, your doctor will want to stop triggers that cause inflammation. Triggers can be stressors, heavy metals, and environmental toxins like mold.
      • Finally, your doctor will implement therapies to regulate and boost your immune system so it can do its job in protecting your child’s body.



With the help of the right specialist, your child can recover completely, as many children do. Once treatment is complete, however, your job as a parent should continue in the form of prevention.

Taking steps to prevent your child from acquiring streptococcal infection again will help prevent a return of PANDAS and its symptoms.

Prevention includes properly washing hands throughout the day to keep bacteria from spreading. Now that masks are being worn to prevent the spread of COVID19, they can also be worn to avoid the spread of strep. However, don’t forget to clean your child’s mask too.

Finally, teach your child to avoid sharing personal items with others unless they have been cleaned first.

Your child can still have a fun, healthy life after PANDAS Syndrome.


Check This Out!

Check out Dr. Omar Morales’ video about a PANDAS and PANS case study: https://www.youtube.com/watch?v=oNI52TIFEGA

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