Did you know that the common Strep bacteria can cause neurological issues in kids, including behavioral issues, obsessive-compulsive behaviors, vocal and motor tics, mood changes and more? This is due to an abnormal immune response to the bacteria, which provokes an auto-immune response. If your child had abrupt onset of aggressiveness, defiance, obsessive-compulsive disorder (OCD) or other behavioral symptoms like anxiety and depression, they might have developed this disorder known as PANDAS. PANDAS and it’s impact on behavior in kids is an area that is still being explored – but as awareness grows, more children are getting the help they need.
Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus Infection, or PANDAS, may develop in children creating a wide symptomatic picture. Criteria for PANDAS includes an abrupt onset of symptoms in children before puberty, with parents often being able to recall a specific time that their child’s behavior had begun to change.
Presence of significant obsessions, compulsions, and/or tics seemingly pop up out of nowhere, which is a major diagnostic criterion for PANDAS. Other symptoms include emotional lability, deterioration in academic performance, personality changes, bedtime fears, bedwetting, fidgeting, sensory defensiveness, irritability, impulsivity, and distraction.
Research is showing that this disease process is 3X more common in young boys than girls. Group A Beta Hemolytic Streptococcus is the main bacterial offender, and symptoms usually appear within 6 weeks of infection.
How Does Strep Infection Become Auto-immune?
The auto-immune response happens through a process of molecular mimicry. What that means is that the strep bacteria start to take on some of the properties of our own cells, and our immune system gets confused as to who is the good guy (our own tissues) and who is the bad guy (the bacteria).
Our immune system creates antibodies against the strep bacteria. One of the parts of the bacteria that is tagged by our immune system has resemblance to a component of our neuronal cell membranes. Therefore, our immune system, despite trying to do the right thing, starts seeing our neuronal cell membranes as problematic and attacking them too. And that’s how strep bacteria can produce neurological problems.
Why do some children develop PANDAS while others do not?
This is a multi-faceted question, but it is hypothesized that children are more vulnerable based on the integrity of their blood-brain barrier. The blood-brain barrier is one of our defense systems to keep harmful substances out of the brain. If it is weakened, then those antibodies that have been created can more easily penetrate and have access to the neuronal tissues that they can react against, and thus damage. Toxicity is one of the major factors that weakens the blood-brain barrier; inflammation is another. Gluten can increase the permeability of the blood-brain barrier through increasing production of zonulin, a substance that makes the gut lining and the blood-brain barrier more leaky. You can read more about zonulin and the brain here.
If this sounds like your child, and you want to learn more about PANDAS including testing and treatment options, you might be interested in my new course, Five Infections That Can Cause Behavioral Issues in Children. Strep/PANDAS is one of the five covered, along with Candida, Clostridia, Borrelia (Lyme disease), and Bartonella.