PANDAS – Does it Exist?
19th April 2019
I first started seeing children with PANDAS about 9 years ago. PANDAS is an acronym for “Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus”.
In simple terms this means that children, following a streptococcus (“Strep’) infection get unusual features such as tics (uncontrolled abnormal movements), obsessive compulsive behaviours, start wetting and may also have difficulty eating.
Streptococcus is a common bacterium that causes tonsillitis, sore throats and chest infections amongst other things. The association between streptococcal infection and abnormal movements (called Sydenham’s Chorea or St Vitus’ dance) was first made in 1802. This was in association with a condition called rheumatic fever.
Rheumatic fever is a condition which occurs after streptococcal infection where you can get inflammation of the heart, joints, skin and brain. The increased use of antibiotics has led to a decrease in the incidence of rheumatic in Europe over the past 100 years. However, the link between streptococcus and these physical problems has not disappeared. It makes complete sense that PANDAS is a rheumatic fever like disease which has been modulated by the use of modern therapies and health interventions such as immunisations.
So, what happens? How does this simple bacterium cause such problems? In fact, it’s not the bacterium but the body’s response to this infection that is the problem, and this explains why cases of PANDAS run in families, because of a genetic predisposition. When you get a streptococcal infection, your body produces antibodies to fight the infection and get rid of the bacterium. The problem in PANDAS is that the antibody that is produced also recognises a part of the brain known as the basal ganglia and sticks to it. This stimulates this area of the brain resulting in tics and obsessions or compulsions. We call this phenomenon “genetic mimicry” the proteins on the surface of this part of the brain look very similar to the surface of the streptococcus and the antibodies are doing what they are designed to do!
So, if you accept that rheumatic fever exists (which most health professionals do) then it is a completely logical step to accept that PANDAS exists.