PANS/PANDAS - What is it?
PANS : Pediatric acute-onset Neuropsychiatric syndrome
PANDAS: pediatric autoimmune neuropsychiatric disorder associated with strep
PANS is a broad term that includes all the neuropsychiatric disorders that are associated with numerous infections such as Mycoplasma, Lyme’s, Influenza, and Streptococcus bacteria, while PANDAS is associated strictly with Strep.
PANS/PANDAS is a clinical diagnosis based on subjective criteria. However, to help doctors with quick and effective diagnosis, criteria have been developed (1). PANS/PANDAS is defined as the sudden onset of OCD, along with other symptoms such as:
Tics
Urinary Frequency
Sleep Disturbances
Eating Disorders
Separation Anxiety
PANS/PANDAS Diagnostic Criteria (1)
PANS/ PANDAS at SCHOOLS
pans/ pandas diagnosis at schools can play a crucial role
Since PANS/PANDAS is a clinical diagnosis, schools can play a very important role in the diagnosis of new patients and in providing crucial support needed by existing patients. The onset of PANS/PANDAS is associated with a dramatic, “overnight” change in behavior, such as a sudden decline in school performance, and the appearance of anxiety in a non-anxious child or adolescent.
School staff and nurses should careful watch out for PANS/PANDAS symptoms after infections. Infectious trigger can vary from Strep to Lyme’s, Influenza, and others.
Sudden changes may include:
Sudden decline in academic performance, especially mathematics or other visual-spatial skills
Deterioration in handwriting
Separation Anxiety
As PANS/PANDAS is still a relatively unknown illness, school nurses and staff often recognize the illness’s symptoms without recognizing the illness itself.
Urinary Frequency: Increased urinary frequency in children in the absence of a urinary infection may be a symptom for PANS/PANDAS.
Disordered Eating: Sudden dietary restrictions such as the refusal to consume certain types of foods may be a symptom for PANS/PANDAS/
Separation Anxiety: Extreme separation anxiety in children can also be as a symptom for PANS/PANDAS. The child will not leave the parents or caregiver, and will want them to be present with them all the time
Handwriting Skills
One symptom of PANS/PANDAS is a deterioration in handwriting skills. Sample of the changes in handwriting is shown below
Source: AutismGPS.com
Deterioration in Math and Visual-Spatial Skills
“ BEFORE PANS - John had always been excellent in math”
” AFTER PANS - ...he suddenly missed relatively easy questions on math tests”
Source : Epidemic Answers
PANS/ PANDAS patients show sharp deterioration in math and geometry skills
Another classic symptom in several PANS/PANDAS patients is the sudden deterioration in math skills and subjects such as geometry and visual-spatial skills.
Educators and staff should keep careful watch of this symptom.
Sudden Anorexia
Source : Medscape
PANS/ PANDAS kids sometimes show eating restrictions and anorexia
PANS/ PANDAS patients can sometimes show severe eating restrictions. An adolescent who enjoys typical Indian food and rarely had seafood may suddenly stop eating Indian food and begin solely consuming seafood. In some severe cases, patients have been reported to stop eating food and have had to use a GI tube. However, once treated, patients are noted to return to their pre-illness eating habits.
Case History
An eight year old boy who presented with a two month history of significant weight loss, behavioral abnormalities, and a history of recurrent Strep Infections. The patient had been taught ‘healthy eating’ at school. He subsequently started reading labels on food packages, avoided all trans-fats, and minimized his fat and simple carbohydrate intake. He was concerned about weight gain and believed that he was ‘too fat’. He then began looking at his abdomen and at himself in the mirror numerous times daily. He became suspicious of what his mother might be putting in his food and began only eating packaged foods that he could prepare himself, which amounted to about 200 calories daily.
Behavior Regression
PANS/pandas patients may often demonstrate behavioral regression during flareups and treatment
PANS/PANDAS patients often times show behavioral regression, such as “baby-talk” and child-like behavior.
Source: MoleculeraLabs