What is Pans/Pandas?

PANS is an acronym for pediatric acute-onset neuropsychiatric syndrome. It is an autoimmune condition in which the body’s immune system has a misguided response to infections and environmental exposures. This immune response mounts an attack on the basal ganglia (the main “motor circuit board”) of the brain rather than the infection. When this happens, there can be an intense onset of neurological behaviors such as rage, aggression, attention deficit hyperactivity disorder (ADHD), food restriction, obsessive-compulsive disorder (OCD), depression, anxiety, loss of fine motor skills, sensory issues, emotional dysregulation, and more. 

Often children who have PANS have had a recent infection—either viral or bacterial, such as streptococcus (more commonly known as strep) or Lyme disease—as well as continued environmental exposures, such as mold and metal toxicity, glyphosate, and more. Stress, trauma, and adrenal fatigue can also play a part in taxing an already-struggling immune system, leading to further compromise. When the immune system is overwhelmed with these risk factors, it becomes susceptible to an autoimmune response that resembles mental illness. 

Furthermore, because the immune system is preoccupied attacking the basal ganglia, it is not efficiently eliminating the toxins and infections that began the autoimmune cascade and makes way for opportunistic pathogens and infections to thrive.  

PANDAS is a subset of PANS, and stands for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. 

The symptoms of PANDAS manifest in similar ways, but are often more intense than symptoms of PANS and are triggered specifically by a strep infection. These strep infections are not always associated with the “strep throat” that we all are familiar with as parents and caretakers. Often, streptococcal bacteria can “hide” in the body in places other than the throat area, only making itself known through symptoms we would not usually associate with an infection.

Although both disorders claim to have “acute onset,” there is emerging evidence that infections, environmental exposures, and stressors in utero can create “soft symptoms” from birth, making it hard to differentiate PANS/PANDAS from other neurological conditions. Similarly, if there are enough preexisting conditions, symptoms can arise in early toddlerhood and resemble classic toddler behavior, such as meltdowns and severe emotional highs and lows.

Although this disorder is overwhelming and can have intense symptoms, there is so much hope for children who are struggling. If you suspect that your child may have PANS/PANDAS, it can be helpful to pay attention to when these symptoms “flare” and when your child seems to be at their best. Taking notes on your child’s behavior as well as possible triggers is the first step—and having curiosity about when they seem “off” will help you attune to their needs more quickly.

If your child is struggling, it is vital that you seek wise and kind professionals to help you navigate this journey. Searching for a doctor who is literate in streptococcal infections, Lyme disease, and/or mold illness is a good starting point. Often, alternative medicine is where families find the greatest healing for PANS/PANDAS. Use your intuition as you seek medical care, because you know your child best.

DISCLAIMER: This site is for educational purposes only and does not substitute for professional medical advice. I am not a doctor; I am a mom who has parented three children with PANS/PANDAS, and this is an overview of my research and firsthand experience. Please seek professional medical counsel if this information resonates with you.