Introduction
When we hear the word “Pandas,” our minds immediately go to the cute, furry black and white bears. However, Pandas disease, also known as PANS (Pediatric Acute-onset Neuropsychiatric Syndrome), is a condition that affects many children. It is a frustrating and often-misunderstood illness that can cause a range of severe psychiatric symptoms. In this article, we’ll delve into what Pandas disease is, the symptoms associated with it, diagnosis, treatment options, and some myths and misconceptions about it.
Pandas disease affects an estimated 1 in 200 children, with most cases found in children around the age of six. However, it is thought that this may be an underestimation because Pandas Disease is not yet widely recognized by healthcare professionals.
Overview
Pandas disease is a neurological disorder that affects children, typically between the ages of three and twelve. It is an autoimmune disorder that presents like sudden, acute, and debilitating psychiatric or neuropsychiatric symptoms. Children with Pandas disease often develop obsessive and compulsive behaviors, tics, anxiety, and emotional instability. They tend to have sudden and dramatic changes in personality, mood, and behavior.
While the exact causes of Panda’s disease are unknown, it is thought to be associated with bacterial or viral infections that trigger a misdirected immune response in some children. Some experts believe that the antibodies produced to fight off the initial infection mistake brain tissue as foreign tissue, leading to the development of the Neuropsychiatric symptoms seen in Pandas disease.
Symptoms of Pandas disease
The symptoms of Pandas disease can be severe and sudden, and they may include:
- Obsessive-compulsive behavior
- Tics, or involuntary movements
- Anxiety and emotional instability
- Sudden and dramatic personality changes
- Sleep disturbances
- Lack of appetite
- Severe separation anxiety and depression
- Decrease in motor skills
- Frequent urination
- Mood swings and tantrums
It is important to note that just because a child has one or more of the listed symptoms does not mean they have Pandas disease. However, if a child suddenly and dramatically develops these symptoms, it is essential to seek medical attention.
Diagnosis of Pandas disease
Doctors diagnose Pandas disease by looking for certain clinical criteria. These criteria include:
- The sudden onset of neuropsychiatric or psychotic symptoms
- Prepubertal onset
- Relapsing-remitting course of symptoms
- Association with streptococcus or another infectious agent
- Onset of symptoms in a matter of days or weeks
If a child meets these diagnostic criteria, doctors will run a series of tests to rule out any other possible medical conditions. A healthcare professional will typically take a detailed medical history and perform a physical and neurological examination.
Treatment options for Pandas disease
The standard therapeutic approach to Pandas disease is to remove or treat the underlying infection with antibiotics. The antibiotics commonly used are penicillin and azithromycin. Typically, the antibiotics are given for about 4-6 weeks.
In addition, psychotropic medications may be prescribed to target the psychiatric symptoms associated with Pandas disease, such as anxiety and depression.
In more severe cases, Intravenous Immunoglobulin (IVIG) is given. This intravenous infusion of human blood plasma with concentrated antibodies can potentially help reverse the immune system dysfunction that is responsible for causing Pandas Disease. ACE inhibitors, and other medications that modify inflammation, are also sometimes used.
Personal Story
Understanding the impact of Pandas Disease is best demonstrated by personal stories. A mother, Tina, shared her experience with Pandas, her daughter’s diagnosis, and the subsequent emotional roller coaster her family went through:
“My daughter was a typical bubbly and active seven-year-old. She loved going to school and playing with her friends. However, one day, she began to experience sudden mood swings, cognitive problems, and tics. We were all alarmed because this was a big change from her usual self. After a few visits to different doctors, we finally saw a neurologist who diagnosed her with Pandas Disease after we did a blood test. It was like she had already lost a year of her life, and we had missed something that would have been treatable if only we had known.”
Tina’s daughter received immunomodulatory therapy and began showing improvement after a few weeks. However, the emotional toll it took on her daughter, family, and the exhaustion of seemingly endless medical appointments was challenging.
Myths and Misconceptions
There are many myths and misconceptions around Pandas disease that, unfortunately, can cause harm to those suffering from the illness.
Myth 1: Pandas Disease isn’t real – This is untrue as multiple studies have suggested that Pandas disease is a serious condition with valid diagnostic criteria that health providers should know about.
Myth 2: It’s all in the child’s head – Pandas disease is not a psychiatric disorder that the child is making up. The symptoms are real and have deep neurological roots.
Myth 3: Antibiotics are the only treatment -While antibiotics are the standard treatment for Pandas Disease, they may not be enough to treat the symptoms totally. Psychotropic medication and/or IVIG treatment may also be necessary.
These misconceptions can lead to delays in diagnosis and appropriate treatment, which would lead to devastating consequences for the child and family.
Expert Interviews
There are medical professionals who have been working on the diagnosis and treatment of Pandas disease. Dr. James F. Leckman, a child psychiatrist, said in a recent interview, “One of our biggest focus should be raising awareness about Pandas Disease and educating healthcare providers.”
Dr. Leckman also advises that parents seek out a medical professional with experience in treating Pandas Disease, as it is not yet widely understood, which could hinder successful treatment.
Treatment Options
The earlier the diagnosis of Pandas disease, the better the outcome. Seeking treatment for the underlying infection via antibiotics is imperative. Psychotropic medicines such as antidepressants, anti-anxiety medications, or antipsychotics may be prescribed to help with reducing psychiatric symptomatology.
There is also research to show that specific diets, such as gluten-free and dairy-free diets, may help reduce the inflammation associated with Pandas disease.
Sometimes, when none of the conventional treatments is effective, doctors may recommend IVIG treatment to manage the disease. This treatment involves a transfusion of healthy antibodies that help regulate the immune system.
Conclusion
In conclusion, Pandas disease is a complicated and often misunderstood illness. It is a neurological condition that causes sudden psychiatric symptoms in children and adolescents. As parents, teachers, and healthcare providers, the most important thing we can do is to spread awareness and debunk myths about Pandas Disease. Anyone who suspects Pandas disease should seek immediate medical attention.
We hope that with better awareness, accurate diagnosis, and effective treatment options, we can improve the quality of life of those suffering from Pandas disease and their families.
