Understanding PANS and PANDAS: A Holistic Approach With Homeopathy

Understanding PANS and PANDAS: A Holistic Approach with Homeopathy

Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) are complex conditions that can profoundly affect children and their families. These disorders are characterized by a sudden onset of neuropsychiatric symptoms, often triggered by infections or immune responses to toxins and toxicants in the environment of the affected child. For parents seeking alternative or complementary approaches to support their child’s recovery, homeopathy offers a gentle, individualized option to address the symptoms holistically. In this blog, we’ll explore what PANS and PANDAS are, their symptoms and causes, and how homeopathy can help. 

What Are PANS and PANDAS?

PANDAS is a condition where a Group A Streptococcus (GAS) infection, such as strep throat or scarlet fever, triggers a sudden onset of neuropsychiatric symptoms in children, typically between ages 3 and 12 (but it can happen in teenagers as well). The immune system, in response to the infection, crosses the blood brain barrier and launches an autoimmune attack on the brain.  This is thought to cause inflammation and affect the basal ganglia, leading to behavioral and neurological changes. 

PANS is a broader diagnosis that includes PANDAS as a subset. Unlike PANDAS, PANS is not limited to streptococcal triggers and can be associated with other infections (e.g., Mycotoxins from mold, Lyme disease) or other environmental or immune stressors. PANS involves a sudden, dramatic onset of obsessive-compulsive disorder (OCD) or restrictive eating, along with at least two other neuropsychiatric symptoms.

The Diagnostic Criteria

The exact diagnostic Criteria for PANS and PANDAS is listed below.

Requirement 1: abrupt, dramatic onset of obsessive-compulsive disorder and/or severely restrict food intake

AND

Requirement 2: presence of symptoms from at least two of the following seven categories (similarly severe and of abrupt onset):

1. Anxiety

1. Emotional lability (rapidly changing moods) or depression

1. Irritability, aggression, and/or severely oppositional behaviors

1. Behavioral (developmental) regression 

1. Deterioration in school performance

1. Sensory and or motor abnormalities (new sensitivity to clothes, smells, loud sounds; facial, voice or hand tics; clumsiness)

1. Somatic signs and symptoms (urinary issues or sleep disturbance)

AND

Requirement 3: not better explained by a known neurological or medical disorder.

NOTE: In adults with similar symptoms, we don’t use the terms PANS/PANDAS but refer to these patients as having autoimmune encephalitis.

NOTE 2: ‘Sudden’ is on a continuum. Sometimes these symptoms progress along a slightly slower trajectory but lead to the same conclusion. 

A Closer Look At The Symptoms of PANS and PANDAS

• Obsessive-Compulsive Disorder (OCD): Repetitive behaviors or intrusive thoughts, such as excessive hand-washing or fear of contamination.

• Tics: Involuntary motor or vocal movements, like eye blinking or throat clearing. Or, it can be counting a number of times before engaging in certain behaviors. 

• Emotional and Behavioral Changes: Severe anxiety, separation anxiety, irritability, aggression, or mood swings.

• Cognitive and Motor Issues: Difficulty concentrating, declining school performance, handwriting deterioration, or clumsiness.

• Other Symptoms: Sleep disturbances, bedwetting, urinary frequency, sensory sensitivities, or restricted eating.

These symptoms often follow a relapsing-remitting course, worsening with subsequent infections or triggers, and can significantly disrupt a child’s daily life.

Causes and Pathophysiology

The exact causes of PANS and PANDAS are not fully understood, but they are believed to involve an autoimmune response where antibodies, produced to fight infections, cross-react with brain tissue (a process called molecular mimicry). For PANDAS, this is specifically linked to GAS infections, while PANS may involve multiple triggers. Research suggests involvement of the basal ganglia, which regulates movement and behavior, and immune markers like CaMKII activation or anti-neuronal antibodies. Genetic predispositions and frequent infections may increase risk.

Conventional Treatment Approaches

Conventional treatment for PANS and PANDAS typically involves a three-pronged approach:

• Antibiotics: To treat active strep infections in PANDAS (e.g., penicillin, cephalosporins). Long-term prophylaxis is controversial and lacks strong evidence.

• Immunomodulatory Therapies: Steroids, intravenous immunoglobulin (IVIG), or plasmapheresis may reduce inflammation in severe cases, though evidence is limited.

• Psychiatric and Behavioral Interventions: Cognitive-behavioral therapy (CBT),        selective serotonin reuptake inhibitors (SSRIs), or habit reversal training for tics and OCD symptoms.

While some families explore conventional options like antibiotics or psychiatric medications for PANS and PANDAS, these often provide incomplete relief and may carry side effects. Homeopathy, by contrast, offers a gentle, individualized approach to address the root causes and support the whole child—body, mind, spirit and emotions.

How Homeopathy Can Help

Homeopathy is a holistic system of medicine that uses nano doses of substances to stimulate the body’s self-healing mechanisms. It is individualized, matching remedies to a patient’s unique physical, emotional, and mental symptoms. For PANS and PANDAS, homeopathy may offer supportive care by addressing the whole person, reducing symptom severity and improving overall well-being. Homeopathy can be used alone or in conjunction with conventional medicine.  Below are key ways homeopathy may help, along with commonly considered remedies from classical homeopathic Materia Medicas (e.g., Boericke, Clarke, Kent).

Homeopathic Approach to PANS and PANDAS

Homeopathy focuses on the totality of symptoms, including physical (e.g., tics, sleep issues), emotional (e.g., anxiety, irritability), and behavioral (e.g., OCD, aggression) aspects. Since PANS and PANDAS often involve a post-infectious immune response, remedies are selected to address inflammation, neurological sensitivity, and emotional distress. A certified homeopath tailors remedies to the child’s specific presentation, considering triggers like infections or stress.

Commonly Indicated Remedies

The following are some of the remedies that may be considered for PANS/PANDAS symptoms. Always consult a qualified homeopath for individualized prescribing, as remedies depend on the child’s unique symptom picture, which takes into account many factors.

1. Stramonium

Indications: For intense fear, anxiety, or aggression with sudden onset, especially if the child seems “out of control” or has night terrors. Stramonium suits cases with violent behaviors, tics, or neurological symptoms resembling PANS/PANDAS. (Homeopathy is not diagnosis dependent but rather treats the symptoms that are expressing, regardless of the diagnosis).

Key Symptoms: Sudden rage, fear of the dark, stuttering or tics, worse at night. 

Use Case: Helpful for children with severe anxiety, aggression, or tics triggered by infections.

2. Hyoscyamus

Indications: For tics, compulsive behaviors, or inappropriate actions (e.g., picking at clothes, muttering). The child may be restless, jealous, or exhibit clingy behavior, aligning with PANS/PANDAS separation anxiety.  

Key Symptoms: Nervous agitation, twitching, obsessive actions, talkativeness. 

Use Case: Suits children with tics and compulsive behaviors post-infection.

3. Belladonna 

Indications: For sudden-onset symptoms with intense inflammation, such as fever, flushed face, or neurological agitation. It may help with tics, irritability, or sensory sensitivities (e.g., to light or sound).

Key Symptoms: Sudden onset, hot head, cold extremities, restlessness, sensitivity to stimuli.  

Use Case: Useful if symptoms started abruptly with fever or neurological sensitivity.

4. Ignatia  

Indications: For emotional lability, mood swings, or separation anxiety, common in PANS/PANDAS. The child may be sensitive, weepy, or have contradictory emotions.  

Key Symptoms: Mood changes, clinginess, sighing, sensitivity to stress.  

Use Case: Ideal for children with emotional volatility or anxiety.

5. Carcinosin  

Indications: A constitutional remedy for children with a history of recurrent infections, perfectionism, or suppressed emotions. It may help in chronic or relapsing PANS/PANDAS cases.

Key Symptoms: Obsessive tendencies, family history of autoimmune issues, sensitivity.  

Use Case: Consider for relapsing symptoms or a family history of autoimmune disorders.

6. Arsenicum album 

Indications: For OCD-like symptoms, anxiety, or restlessness with a need for order. The child may fear contamination or have compulsive behaviors.

Key Symptoms: Anxiety, compulsive rituals, restlessness, worse at night. 

Use Case: Suits children with compulsive behaviors or anxiety-driven symptoms.

Homeopathic Treatment Considerations

• Homeopathy requires a detailed case history, including the child’s emotional state, physical symptoms, and triggers. A homeopath may explore infection history, family health, and specific behaviors to select the best remedy.

• Though parents can effectively treat their children for acute ailments, PANS and PANDAS may require a skilled homeopath for accurate remedy selection.

• Homeopathy is gentle and safe for children when prescribed correctly.

• Physical, emotional, and neurological symptoms can be addressed with a well chosen remedy.

• Reliance on medications with side effects is reduced or eliminated.

• Emotional well-being is supported, reducing anxiety or irritability

Considerations

At times more than one remedy may be needed to address multiple layers of the child’s condition. 

Gentle support for detoxification and organ support may be needed to aid in a child’s healing using Gemmotherapy and/or UNDAS.

Summary

PANS and PANDAS are challenging conditions that can turn a child’s life upside down with sudden neuropsychiatric symptoms. Homeopathy offers a holistic approach to alleviate emotional, behavioral, and physical symptoms. Remedies like Stramonium, Belladonna, Hyoscyamus and Carcinosim may help address acute flares, as well as supporting long-term recovery. By addressing the whole child—body, mind, spirit and emotions—homeopathy can play a valuable role in the journey to healing.

If you’re navigating PANS or PANDAS with your child and would like help, please contact me for a consultation or a complementary discovery call: livingwellhomeopathy.com Wishing you strength and hope on this path to recovery!