PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections. 

What is it?

This is a medical disease caused by an autoimmune reaction. PANDAS is a subset of PANS, Pediatric Acute-onset Neuropsychiatric Syndrome. PANS can be triggered by strep, pneumonia, Lyme Disease, Coxsackie Virus and more.

Symptoms include OCD, food aversion/restriction/anorexia, tics, joint pain, handwriting decline, math-fact loss, depression, rage, oppositional/defiance, ADHD and more. Often, but not always, there is a sudden onset. People who react to strep might never show signs of a sore throat. Throat cultures might not be positive; blood tests might be needed to determine if the body has recently been exposed to strep. PANS can even be a result of a reaction to a vaccination.

What happens?  

When the person is exposed to germs, the body's antibodies attack the person's brain. It is thought that the antibodies cross the blood brain barrier and attack the basal ganglia. Therefore, one might not see the afflicted person react with flu or a cold symptoms, but instead have an increase in tics, OCD, intrusive thoughts, rages, etc.

How is this diagnosed?

Blood work will show elevated strep titers or mycoplasma titers. The Cunningham Panel is a new test designed to show PANS/PANDAS. Clinical symptoms are also often integral to the diagnosis.

How is this treated?

At this point in time, antibiotics are frequently used. IVIG (immunoglobin) or plasmapheresis can clean up some of the rogue antibodies. Homeopathy has been used with success for some patients. Supplements and other natural medications can help. Many families are looking at other issues as well: methylation, MTHFR, yeast, parasites, heavy metals.


Lyme and co-infections should always be tested using at least a Western Blot, with all bands examined by a Lyme Literate practitioner. Igenex and Advanced Labs have been recommended. The ELISA doesn't give much information and CDC standards for Lyme are old and not acurate. The sicker a person is with Lyme, the fewer the antibodies that person will make, resulting in a test that depicts a false negative. A Lyme culture is now on the market and this is supposedly more accurate. Lyme frequently causes PANS in children.

The future

There are success stories. There is hope. There are children who are better. We need to keep searching for ways to heal. We need to support the doctors who are courageous enough to deal with a disease that hasn't yet been recognized enough by others in the medical community and beyond. Different groups--New England PANDAS/PANS Parent Association, PANDAS Network and more--are pushing for awareness, education and legislation. Join these groups for more information and to add your voice.