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PANS and PANDAS
A sudden, dramatic change in a child after an infection deserves a careful look. We support the immune, inflammatory, and neurological terrain alongside your pediatrician.
What you may be noticing
Your child changed almost overnight. Sudden obsessions or compulsions, severe food restriction, intense separation anxiety, rage, tics, new bedwetting, handwriting that deteriorated, or trouble sleeping. Often it followed a strep infection, a virus, or another illness. You feel as if your child has been replaced, and you are searching for answers.
A sudden neuropsychiatric change in a child needs prompt medical evaluation by a pediatrician or specialist to look for infection and rule out other causes. My work is comprehensive support alongside that care.
Why it is rarely one thing
PANS describes an abrupt onset of obsessive compulsive symptoms or severe food restriction together with other neuropsychiatric symptoms. PANDAS is a subset in which the trigger is thought to be a streptococcal infection. The leading hypothesis is that an immune response affects the basal ganglia, the region that coordinates movement, habit, and emotion.
I view this as brain inflammation with several possible sparks: infection, including strep, mycoplasma, and viruses; autoimmune signaling; and toxins. In my clinical experience, mold in the home is a frequent contributor that adds to the load. That observation is a working hypothesis. The science is still developing, there are no validated biomarkers that confirm the diagnosis, and antibody panels remain unproven as diagnostic tests. Diagnosis rests on careful clinical evaluation.
Patterns we look for
- Infection history: strep, mycoplasma, viral infections, and recurrent illnesses.
- Inflammation and immune balance.
- Neuroinflammation affecting basal ganglia function.
- Toxic burden, especially mold exposure and lead.
- Gut microbiome balance and intestinal permeability, especially after repeated antibiotics.
- Nutrient status: zinc, iron, vitamin D, and omega-3 levels.
- Retained primitive reflexes and sensory processing changes.
- Frontal inhibition, motor control, and sleep.
How I evaluate it
A comprehensive functional neurological exam, adapted for children and begun through play, assesses eye movements, tics, coordination, balance, primitive reflexes, and sensory responses, and tracks change across flares and calmer periods.
Functional labs are coordinated with your pediatrician and may include strep titers and throat culture, mycoplasma testing, a complete blood count, inflammatory markers, ferritin, zinc, vitamin D, blood lead, and comprehensive stool analysis. Urine mycotoxin testing and a home mold assessment are considered when symptoms flare at home.
How we address it
Order matters, and with children it starts with the environment.
- Coordinate with your pediatrician for infection testing and any treatment of active infection.
- Address the environment first: mold, lead, and a home exposure review.
- Calm the nervous system with predictable routines, sleep support, and gentle breath and vagal games.
- Restore the gut and immune balance, especially after antibiotics, with food reactivity in view.
- Open drainage pathways gently together: bowel regularity, hydration, and lymphatic movement.
- Replenish nutrients that support immune regulation and neurotransmitter balance, and reduce neuroinflammation.
- Rebuild with brain-based rehabilitation through play: primitive reflex integration, frontal inhibition training, and sensory regulation, in short morning and evening routines a parent can lead.
A simple symptom diary noting flares, illnesses, and exposures can reveal patterns that guide the plan. Children are not meant to live in chronic fight-or-flight patterns.
Your child is still there. The work is to calm what is in the way.
Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.