Common Triggers of PANS/PANDAS

PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) are conditions known to be triggered by infections and exposures, primarily bacterial, fungal, or viral. The most frequently implicated trigger in these disorders is a Streptococcal infection. A strep infection can cause strep throat, however, it can sometimes impact other areas of the body, including the central nervous system, which is believed to be a major factor in the onset of PANS/PANDAS.

In addition to Streptococcal infections, other infections can also serve as triggers for PANS/PANDAS. Lyme disease, caused by Borrelia burgdorferi bacteria and transmitted through tick bites, is one such trigger. Mold-related exposures, often associated with mycotoxins produced by certain molds, have also been linked to PANS/PANDAS. Additionally, viral infections such as HHV-6 and covid infections are also possible triggers.

The common thread among these triggers is the potential for the immune system to mount an abnormal response. In PANS/PANDAS, the immune system's reaction to these infections becomes misdirected, where it produces antibodies that mistakenly attack healthy brain cells, particularly those in the basal ganglia, also known as Basal Ganglia Encephalitis. This autoimmune response within the central nervous system ultimately leads to the neuropsychiatric symptoms characteristic of these disorders.

It's important to note that not all individuals who experience these infections will develop PANS/PANDAS, and there may be additional genetic or environmental factors at play that determine who might become susceptible. Understanding these common triggers is essential for early recognition and intervention, as addressing the underlying infection and immune dysregulation can be key to managing PANS/PANDAS effectively. Additionally, ongoing research is shedding light on other potential triggers and contributing factors, further enhancing our understanding of these complex disorders.