The opposite of the comical black and white bears, medical PANDAS are not at all entertaining.
The assumed mechanism by which it creates havoc only in some patients is via a patient’s immune system which responds to a streptococcal infection excessively. It is thought that the antibodies, created in response to this infection, end up getting through the blood-brain barrier, and then impact areas which control things like mood, emotions, behaviour, cognition and sensations.
These symptoms may manifest very shortly after a streptococcal infection. This infection, often known as “strep throat”, is due to bacteria in the upper airway which is typically diagnosed via a throat swab.Photo by abezikusThe above description of PANDAS may sound simple but, in real life, the presentation and diagnosis can be difficult, controversial and confusing. Not all clinicians are aware of PANDAS – or if they are aware they may feel it is often over-diagnosed.
Meanwhile, some families are confused and exasperated, with good reason. They may Google resources and find clinicians who promote themselves as PANDAS experts. Some of these experts are very good but have long wait times. Because swabs are not always definitive, patients may be subjected to a number of blood tests where clinicians search for antibody levels that keep on rising. These are known as ASOT titers – a fourfold increase may be helpful to confirm the diagnosis.
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