If a child suddenly develops behavioral and neurological symptoms after a strep infection, PANDAS should be suspected. PANDAS is a neuro-immune disorder in which a strep infection triggers brain inflammation and the immune system starts to attack and destroy brain tissue, causing a sudden onset of neurological symptoms.

PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.

PANS, or Pediatric Acute-Onset Neuropsychiatric Syndrome, is similar, except environmental factors or other infections trigger symptoms.

PANDAS diagnosis criteria

• Significant obsessions, compulsions, tics
• Abrupt onset of symptoms or relapsing and remitting symptom severity
• Onset prior to puberty
• Association with strep infection
• Association with neuropsychiatric symptoms, including PANS symptoms

PANS diagnosis criteria:

Abrupt, dramatic onset of OCD or severely limited food intake and the addition of at least two of the following:

• Anxiety
• Emotional swings and/or depression
• Irritability, anger, oppositional behavior
• Regression
• School performance deteriorates
• Sensory or motor abnormalities
• Sleep disturbances, urinary frequency, bed wetting

Functional neurology help for PANDAS/PANS

Because PANDAS and PANS involve the immune system, management involves testing markers for inflammation, infections, immune function, and brain autoimmunity (when the immune system attacks and destroys brain tissue).

It’s also helpful to conduct a functional neurology exam to identify compromised areas of the brain, as well as to establish a baseline of brain function.

Repeat testing can show you how well PANDAS/PANS protocols are working. Functional neurology rehabilitation may also help with recovery. For instance, therapies targeting different areas of the brain can calm an over active immune system and over activation of pathways.

Functional medicine help for PANDAS/PANS

Additionally, functional medicine strategies may include removing inflammatory triggers from the diet and the environment; nutritional therapies to lower inflammation and support brain health; addressing blood sugar, gut health, and toxicity; supporting neurotransmitters; and repairing mitochondrial function and the blood-brain barrier.

Conventional medical help for PANDAS/PANS

Therapies from the conventional model that have been shown to help include steroids and NSAIDs for inflammation; plasmapharesis (plasma exchange) to reduce antibodies; intravenous immunoglobulins (IVIG) to support immune modulation; and immune modulating medications when necessary.

Understanding the PANDAS/PANS brain

When PANDAS/PANS strikes a child — an estimated 1 in 200 children are affected — parents become both frightened and devastated. Understanding what is happening in the brain can help alleviate anxiety.

The functional neurology exam can help identify which pathways in the brain are affected. PANDAS/PANS typically affects communication loops between the basal ganglia, cerebellum, and frontal lobe.

Act quickly to address PANDAS/PANS

PANDAS/PANS is a significant and scary disorder, but taking action quickly improves the chances of an optimal outcome. For more information, contact my office.

More than one in seven children suffer from developmental disorders today. But this doesn’t mean change isn’t possible. The brain is enormously malleable, or plastic, and with the right input on a consistent basis using functional neurology, we often can improve brain function.

Common childhood brain development disorders today include:

• Attention deficit disorder (ADD)
• Attention deficit/hyperactivity disorder (ADHD)
• Asperger’s syndrome
• Autism
• Developmental coordination disorder (DCD)
• Nonverbal learning disability (NLD)
• Obsessive-compulsive disorder (OCD)
• Oppositional defiant disorder (ODD)
• Pervasive developmental disorder (PDD)
• Tourette’s syndrome
• Chronic allergies, asthma, eczema, digestive disorders

How brain development disorders arise

These disorders can arise for a variety of reasons, such as:

• Environmental toxins interfere with normal brain development.
• A viral or bacterial infection interferes with brain development.
• The child has an autoimmune reaction against neurological tissue that prevents normal brain development and function. This can be passed on in utero from the mother or develop in early life due to an environmental, viral, bacterial, or dietary trigger.

Poor brain development unfolds in a variety of ways. For instance, important milestones in brain development, such as crawling, may be  skipped. The brain is a highly complex network of multiple pathways. Proper formation of this network of pathways depends in part on the child going through each milestone of development.

When the brain fails to develop correctly, one hemisphere grows more slowly than the other, giving rise to various disorders that are either left-brain dominant or right-brain dominant. This is why we see kids who are intellectually advanced (left brain) yet socially and emotionally delayed (right brain). As this imbalance progresses, the brain finds it increasingly difficult to network between the hemispheres, causing poor function.

Also, infections and autoimmune attacks against areas of the brain sabotage proper development and hinder function in those pathways. For instance, the basal ganglia, which helps regulate involuntary motor movements, is a common site of viral and autoimmune attack. This can cause disorders such as PANDAS, OCD, Tourette syndrome, and tics.

Start with metabolic health of the brain

Functional neurology also includes addressing the metabolic health of the brain. If the brain is struggling with inflammation, iron deficiency, blood sugar imbalances, or chronic poor health from a bad diet, it will not respond as well to rehabilitation. Additionally, children’s brains require ample healthy fatty acids — EPA and DHA.

Metabolic issues to look out for with brain development disorders include:

• Inflammatory foods (sugars and junk foods) and food intolerances
• Chemical sensitivities
• Chronic infections — bacterial, fungal, or viral
• Digestive issues and leaky gut
• Autoimmune disease (when the immune system attacks and destroys tissue in the body, which can include the brain)

Functional neurology brain exercises for brain development disorders

Fortunately, functional neurology can address brain development disorders.

The types of brain rehabilitation a child needs depends on patient history and a functional neurology examination, which assesses brain function, areas of under and over development, and areas that are over stimulated or under stimulated. The functional neurologist can then tailor exercises to the brain environment and adjust them over time as function improves.

Many families report swift and significant shifts in behavior, mood, sociability, learning, and other brain-based signs.

Ask my office how functional neurology can help if your child has a brain based developmental disorder.

Brain Fog and associated signs and symptoms such as decreased mental clarity, decreased mental performance, increased occurence of loss of keys, and increased occurence of forgeting names with faces should not be shrugged off as old age.  This may be an early sign of neurodegeneration that could progress to Parkinson’s or Alzheimer’s.

How can we know our risk?  Are there lab markers that we can use to give us an indication of where we are on the spectrum of neurodegeneration?  

Yes, there are.  In today’s show we will dive into a couple and discuss what to do about it if your levels of these biomarkers are unhealthy.