Did you know that it is possible for a child (and even an adult) to get an infection, and then to have that infection trigger an autoimmune attack on their brain or other tissues? In a child, this infection can be from streptococcus in the case of the condition called PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Strep) or it can be from other infections or even toxins in the case of PANS (Pediatric Acute Neuropsychiatric Syndrome). It is also becoming more common to see various autoimmune conditions start after having COVID or receiving COVID vaccines.

In children, the symptoms can include the sudden onset of obsessive/compulsive behaviors, bedwetting, separation anxiety, food avoidance, new onset fears or phobias, tantrums or rage attacks, and a decline in handwriting and school performance. This condition can be bewildering and very upsetting to the family, when their previously normal child suddenly has all of these new problems that do not respond to standard interventions. Once this autoimmune attack has begun, anything that “irritates” the immune system can cause the symptoms to flare – including pollen exposure or hay fever, mold exposure, or other infections.

Diagnosing PANDAS/PANS requires having a full awareness of the different ways the condition can present by the practitioner, including an understanding of the different kinds of symptoms that can occur and the timing of the onset of the condition, doing specialized diagnostic tests for the antibodies that are attacking the brain, looking for the underlying infections and/or toxins that can be causing the problem, and then starting specialized treatments that can include treating the underlying infections, modulating and calming the immune system, decreasing inflammation in the brain and body, and even special therapies to help the patient and family cope with what has happened.

With proper assessment and intervention, Autoimmune Encephalitis including PANDAS and PANS can be treated, with a good prognosis and a future full of hope.