Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS)
Source: Behavioural Neurotherapy Clinic
Have you noticed how different your child has been acting ever since he had that sore throat? He seems hyperactive, moody and keeps blinking his eyes. He also has become very particular about the way he does certain things. His teachers say that he’s not paying attention in class and they’re having trouble reading his handwriting.
Your child may have developed what the medical community has named PANDAS. Although rare, PANDAS stands for Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus. What does all that mean? Basically, it means that when the body’s defences are trying to attack the Streptococcal bacteria causing the sore throat, there is some degree of mistaken identity and it also attacks some parts of the brain.
The autoimmune attack is thought to occur on closely related parts of the brain, causing a range of behavioural and emotional problems. When first discovered PANDAS was linked to obsessive-compulsive disorder, Tics and Tourettes syndrome. Mostly because these abnormal behaviours are overt and easily recognised.
Tics can be uncontrollable movements, such as eye-blinking or shoulder-shrugging, or automatic noises such as throat clearing, grunting or saying certain words repeatedly. More recently PANDAS has been associated with a wider range of related behaviours. Affected children can have any combination of the following symptoms:
* Cognitive inflexibility, difficult to reason with, as if stuck on an idea,
* Obsessive/repetitive/compulsive argumentative behaviours,
* TICS (repetitive vocalisations of body movements),
* Tourettes Syndrome,
* Attention deficits and oppositional/defiant behaviours.
The bacteria associated with this disorder are known as Group A Beta-Haemolytic Streptococcus (GABHS). They are also the bacteria associated with rheumatic fever, a disease characterised by heart and joint inflammation that can occur after an untreated strep throat. A type of rheumatic fever with mostly neurological symptoms is Sydenham’s chorea (also known as St. Vitus Dance). Symptoms of Sydenham chorea may occur several weeks to months after the infection and may include poor or diminished muscle control and tone, poor coordination and awkward movements of the face, body, arms and legs.