Understanding PANS and PANDAS: A Guide for Nurse Practitioners

Summary: We've put together this guide – packed with essential information, practical advice, and expert insights – to help you understand these mysterious disorders and provide better support for your patients.

What are PANS and PANDAS?

PANS and PANDAS are two of the most common pediatric autoimmune disorders. PANS stands for Pediatric Acute-onset Neuropsychiatric Syndrome, while PANDAS is short for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections. Both disorders are characterized by the sudden onset of Obsessive Compulsive Disorder (OCD) or a tic disorder. They can also include other psychiatric symptoms such as anxiety, depression, mood swings, and behavior changes.

PANS are thought to be caused by an immune reaction to a viral or bacterial infection, while PANDAS is linked to strep infections. Both disorders can be challenging to diagnose, as they share many symptoms with other mental health conditions. However, some key differences can help clinicians distinguish between PANS and PANDAS. For example, children with PANS typically have a more sudden onset of OCD or tic symptoms, while those with PANDAS tend to have a more gradual onset. In addition, children with PANS may have other neurological symptoms, such as headaches or seizures, while those with PANDAS generally do not.

Treatment for both disorders typically includes cognitive behavioral therapy and medication management. In some cases, children may also require immunomodulatory treatment to help control their symptoms.

How common are PANS and PANDAS?

What is PANS and PANDAS are relatively rare conditions, but PANDAS is thought to be even rarer than PANS. The exact prevalence of PANS is unknown, but it is estimated to affect 1 in 200 children in the United States. PANDAS is even more challenging to estimate because it is often misdiagnosed or not recognized. However, one study found that the prevalence of PANDAS may be as high as 1 in every 150 children.

What are the symptoms of PANS and PANDAS?

There are a few key symptoms that are associated with PANS and PANDAS. They include:

1. Abrupt onset of OCD or other neuropsychiatric symptoms

2. Anxiety

3. Separation anxiety

4. Emotional lability

5. Insomnia

6. Motor or vocal tics

7. ADHD

8. Urinary frequency or urgency

These symptoms can come on suddenly and be very severe, making it hard for kids to function at school or home. The good news is that most kids improve significantly within a few months to a year with proper treatment.

How are PANS and PANDAS diagnosed?

There is no one test to diagnose PANS or PANDAS. Instead, diagnosis is based on a combination of medical history, physical examination, and laboratory tests.

Medical history: To diagnose PANS or PANDAS, your healthcare provider will take a detailed medical history. It will include asking about your symptoms when they started, and if there is a family history of autoimmune disorders.

Physical examination: A physical examination can help rule out other conditions with similar symptoms. Your healthcare provider will also look for signs of infection, such as a sore throat or rash.

Laboratory tests: Several laboratory tests can be used to diagnose PANS or PANDAS. These include:

• Complete blood count (CBC): This test measures the levels of different types of cells in your blood. An increase in white blood cells may be seen in people with autoimmune disorders.

• Sedimentation rate: This test measures the rate at which red blood cells settle in a tube of unclotted blood. A high sedimentation rate may be seen in people with inflammation.

• C-reactive protein (CRP) level: This test measures the level of CRP in the blood. CRP is a protein created by the liver in reaction to inflammation. A high CRP level may be seen in people with inflammation.

Treatment options for PANS and PANDAS

There is no cure for PANS or PANDAS, but there are treatment options available that can help lessen the symptoms and improve the quality of life. Treatment options include:

-Cognitive behavioral therapy: This type of therapy can help children and families deal with the emotional and behavioral effects of PANS and PANDAS.

-Medication: A variety of medications can be used to treat the symptoms of PANS and PANDAS, including anti-inflammatories, antibiotics, antidepressants, and antipsychotics.

-Dietary changes: Some children with PANS or PANDAS may benefit from making dietary changes, such as avoiding triggering foods or taking probiotics.

-Supplementation: supplements such as omega-3 fatty acids or magnesium oxide help reduce symptoms in some children with PANS or PANDAS.

If your child has been diagnosed with PANS or PANDAS, work with their healthcare team to create a treatment plan that best meets their needs.

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