A few weekends ago my little 7-year old niece, Avery, seemed to be coming down with something. While she had no "normal" symptoms of illness, she was exhausted and emotional and just not acting like herself. Just like almost everyone I’ve talked to this past month, a serious case of the icks (colds/flus etc) had torn through their house, leaving my sister-in-law, Heather, to think that the family was just being hit again. But things were a little different… my niece is quiet, easy going. Only now she was hysterical, crying, sobbing and seeming anxiety-ridden and a bit OCD-ish.
This odd for her behavior continued on through the weekend, and into the start of the next week. With no actual physical symptoms, and just worried they had overdone it schedule-wise lately, Heather sent her to school Monday. Halfway through the day, knowing that her behavior was so unlike her, Avery's teacher sent her to the nurse and guidance counselor to see if either of them had any ideas. Neither did, but both were very concerned.
What would cause the general mood and disposition of a happy child to change drastically overnight?
Of course paranoid thoughts filled the heads of those who know and love her. And knowing something just wasn’t right, Heather took Avery to the doctor the following day. While the pediatrician’s first thought was exhaustion, after a few questions about other ailments in the family and finding out that my brother-in-law had been diagnosed with strep throat the week before, he ran a strep test …. That came back positive.
No - Not the cuddly, cute, black and white variety, PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. While this is rare, this can happen to kids when their body's defenses 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. This autoimmune attack is thought to occur on closely related parts of the brain, causing a range of behavioral and emotional problems.
“Typically, a child with undiagnosed PANDAS may be taken to the Psychologist and/or Pediatrician for treatment of an onset or exacerbation of ADHD symptoms, oppositional behaviors or OCD. Stimulant or anti-depressant medication may be prescribed and/or a behavioral intervention or counseling initiated. As the infection passes and the strep antibodies reduce, the symptoms gradually subside and parents and clinicians believe that the intervention was successful. However then there is another strep infection, the symptoms return and the process is repeated. The problem is that the brain is being continuously damaged by the repeated attacks by streptococcus antibodies; and after each attack the recovery of damaged brain tissues may not be as complete as we would hope. Eventually the child may develop a chronic psychiatric disorder.”
Maybe you have heard of this? A few years back, mother Beth Maroney wrote the book Saving Sammy, where she talks about what she and her son went through when he suddenly "caught OCD." This child went through years of therapy and medications and wouldn't leave his room for years before being tested for strep. He's now 20 and is in college.
Or you may have seen articles of the strange "mass psychogenic illness" affecting 18 teenagers in Le Roy, New York? Just last week Dr. Rosario Trifiletti diagnoses the kids with PANDAS stating that:
"eight girls tested show evidence of infection with at least one of these pathogens. Both of these agents have been associated with a PANDAS-like illness with the sudden onset of motor and vocal tics. Thus, a PANDAS-like illness is my working diagnosis, rather than a mass conversion disorder."
While the medical community is still in disagreement over whether or not the Le Roy children actually have PANDAS or if the onset of the symptoms are related to other stresses, it is something to keep in mind. While I hate to be Jenny McCarthy-esque and propogate internet health rumors that may or may not be true, I also know that there are many health issues (like Kawasaki Disease) that are newly discovered and just don't have the years of research defending them yet.
Thankfully, my niece’s pediatrician caught this, and after just 24-hours on antibiotics, she was back to her sweet self. But with ADHD, Autism and many behavior issues on the rise, it makes you wonder how much a simple round of antibiotics may have made a difference.