PANS & PANDAS
PANS is suspected as a culprit in up to 25% of all pediatric OCD diagnoses. Children are often diagnosed with obsessive-compulsive disorder (OCD) or an eating disorder, but the sudden onset of symptoms separates PANS from these other disorders. In addition, they may have symptoms of depression, irritability, anxiety, and have difficulty with schoolwork.
Signs and Symptoms
PANS/PANDAS can affect a wide range of areas from brain development to metabolic processes. The signs and symptoms that are commonly seen include obsessive-compulsive, motor tics, vocal tics, irritability, mood swings, focus or attention diminished, academic/cognitive difficulties, and loss of motor coordination. This may have occurred during the first years of life or later into the teenage years. The one thing you know for sure is that there was a specific event: infection or adverse reaction.
What Are PANS & PANDAS?
PANS is an acronym for Pediatric Acute-Onset Neuropsychiatric Syndrome. PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. The main difference between the two is that PANDAS is explicitly identified using an ASO (antistreptolysin O) lab test that reveals an unresolved strep infection as the primary cause. PANS, on the other hand, may or may not have an identifiable infectious cause. From this point, we will use the term PANS to describe both of them.
While there may be an infectious organism or a specific event that triggers the development of PANS, the origin itself is immune based. An organism or chemical enters through the blood-brain barrier and the immune system does not like this and becomes overactive. During this period of overactivity, it becomes confused and actually starts labeling brain tissue as bad. The region attacked is predominantly the basal ganglia, which is a relay system responsible for regulating emotions, cognition, movement, sensory control, and much more.
Our Approach to Diagnostics and Testing
Our clinicians not only have an understanding of the brain but have extensive knowledge of the immune system. They understand how the immune system and brain interact. This understanding necessitates not only examining your immune health but to assess brain function as well. It is only when both of these systems are functioning optimally that the best results can occur.
How We Evaluate Immune Health:
- Autoimmune Markers
- Food Sensitivity Testing to both cooked and uncooked foods
- Inflammatory Marker Testing
- Genetic Testing
- Viral load Testing
Revive utilizes research-based diagnostics to evaluate function in specific areas of the brain. Looking at eye movements, motor function, sensory function, cranial nerves, cognitive function, balance, and gait. This information allows us to better understand what areas are affected so we can develop a treatment plan that targets those regions and networks to make them stronger and more efficient. These tests include eye movements, motor function analysis, physical exam, cognitive ability and balance.
- The VGN or testing of eye movement gives us a representation of the function of eye muscles, cranial nerves, brainstem nuclei, cerebellum and cortical regions. By measuring things like gaze stabilization, smooth pursuits, saccades, and optogenetics it helps us to differentiate the areas of weakness.
- Motor function analysis enables us to see the strength, tone, and coordination of the movement of muscle groups so we can better understand the regions and networks of involvement. Networks that are utilized in movement are the coordination of movement involve the frontal lobes, parietal lobes, and the cerebellum.
Our Approach to Care
At Revive we specialize in providing treatment to the immune system followed by neurological rehabilitation. Your treatment may include antibiotics, IVIG, supplementation, followed by brain stimulation; such as sensory-motor integration, repetitive transcranial magnetic stimulation (rTMS), hyperbaric oxygen, and rotational therapy.
We offer a unique process that is built to maximize time and results. To reach your personal healthcare goals, it is imperative that your physicians and care providers precisely know your individual story and desires. Your individual goals are the focal point of the comprehensive treatment plan which is based off your exam, diagnostics, and lab results.
Beyond the neurological system, there are many factors that can impact the presentation of PANS: the immune system, diet, sleep, and stress (to list a few). By integrating knowledge of the brain and influence of these factors, we are able to be very specific with targeted therapies which create lasting neurological changes. Your treatment plan is designed specifically for you and is not a protocol.
This plan is executed over 10-15 days. Patients see measurable improvement during their time in our office and continue to make gains once they leave. To help ensure success on your journey of healing, we create and define a plan for you when you go home. This plan may include sourcing local specialist for a safe and effective continuum of care. Our goal is to see each patient continue to build upon the initial results they achieved in our office.
Research on our treatments
Vestibular therapy is a very powerful tool in the world of neurological rehabilitation. When we look at brain development we see that movement drive brain growth and one of the most important areas for sensing movement is the vestibular system. When we utilize rotational therapy to active the vestibular system we see an increase in activating in several cortical regions.