PANS & PANDAS

PANS and PANDAS are neuropsychiatric conditions seen in children and adolescents characterized by sudden and dramatic changes in a child’s behavior, mood, or thinking. With symptoms appearing abruptly—often overnight—these dramatic changes are both frightening and confusing for families.

To make matters more difficult, PANS and PANDAS are conditions that are still not clearly understood across the medical community. Because many of its symptoms present as a psychiatric disorder, like OCD (obsessive-compulsive disorder) or ADHD (attention-deficit/hyperactivity disorder), it is not uncommon for children to be misdiagnosed. Unfortunately it often takes years and multiple doctors’ visits for children to get a proper diagnosis.

At Kaplan Center, we recognize PANS and PANDAS as medical conditions with immune and inflammatory roots, manifesting as psychological disorders.

What Are PANS and PANDAS?

PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) is defined as a sudden onset of OCD (obsessive compulsive disorder) or severely restricted food intake accompanied by additional emotional, behavioral, or physical symptoms following an infection or other trigger to the immune system.

PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is a subset of PANS that is specifically associated with a prior streptococcal infection, such as strep throat.

What Causes PANS and PANDAS?

PANS and PANDAS are both triggered by an infection that sets off an autoimmune reaction causing the body’s immune system to attack the brain and nervous system. The resulting damage to the brain expresses itself in sudden neuropsychiatric and behavioral symptoms. In addition to the triggering infection(s), other contributors can include:

• Genetic vulnerability
• Neuroinflammation
• Gut microbiome imbalances
• Nutrient deficiencies
• Environmental toxins or stressors

Common Symptoms

Each child presents differently because of their genetic makeup and medical history, but the most common symptoms of PANS/PANDAS include:

• Sudden Neuropsychiatric Changes
  • Sudden onset of obsessive compulsive disorder
  • New aversions to food and changes in appetite
  • Severe anxiety
  • Mood swings
• Behavioral and Cognitive Symptoms
  • Irritability/aggression
  • Regression in development or school performance
  • Attention and memory difficulties
• Physical and Neurological Symptoms
  • Sleep disturbances
  • Tics or abnormal movements
  • Sensory sensitivities
  • Urinary frequency or bedwetting
  • Pseudo seizures (these are seizure like behaviors that do not show up on a standard neurological exam)

Diagnosing PANS and PANDAS

There is no one test to confirm PANS or PANDAS, as a result children who are suffering day after day often go misdiagnosed for years. The most important step in diagnosing PANS/PANDAS is finding a physician familiar with this disorder as early recognition and the right medical support are essential and can significantly improve outcomes for patients.

The Kaplan Center is uniquely equipped to support children with PANS and PANDAS through a multidisciplinary, integrative care team with decades of experience in identifying and treating these complex conditions. Following a comprehensive clinical evaluation—including an in-depth medical history and specialized diagnostic testing—your child’s case is carefully reviewed by our team to ensure an accurate diagnosis and personalized treatment plan.

Treatment Approaches

The first step in treating PANS and PANDAS is to determine the underlying cause of your child’s behavior—why the immune system is misfiring and what factors are perpetuating symptoms. We consider every possible contributor including nutritional deficiencies, microbiome health, mitochondrial function, and infections beyond strep.

Our holistic treatment approach is based on the most current research in the field. We will incorporate several evidence-based therapies to heal your child’s immune system, eliminate the bacteria, reduce inflammation, and restore balance.

• Medications to treat underlying infections
• Therapeutic Plasma Exchange
• Anti-inflammatory and immune-modulating treatments
• Nutritional support, including supplementation and IV therapy
• Stress management / lifestyle interventions
• Cognitive behavioral therapy (CBT)

Managing PANS or PANDAS can be challenging, but you are not alone. Having a proactive care plan and the right support is essential. Many children experience meaningful recovery and return to normal functioning when underlying triggers are addressed.

Our goal is not just symptom management—but lasting healing and restored health.