When Strep Strikes the Brain: Understanding PANDAS in Children

As a parent, there are few things more unsettling than watching your child change seemingly overnight. One day, they’re happy and healthy, and the next, they exhibit extreme behaviors—obsessive-compulsive tendencies, tics, mood swings, or even neurological changes. For many parents, these shifts can feel like a mystery. But if you’re dealing with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS), the cause may lie within the complex interaction between strep infections, the immune system, and the brain.

As a functional medicine practitioner and neurologist at Revive Health, I understand the importance of looking beyond the surface. The sudden onset of PANDAS can feel overwhelming, but there’s always an explanation. More importantly, there’s always a way to heal the whole person, starting with identifying the root causes and addressing them through an integrative approach to health.

In this article, I’ll walk you through what PANDAS is, how it affects your child’s health, and holistic strategies to support recovery. I’ll also clear up some common myths and misconceptions about this often-misunderstood condition. For more information on functional medicine treatments for PANDAS, click here to connect with a Revive Advisor.

What is PANDAS Syndrome?

PANDAS is a condition that affects children, typically between the ages of 3 and 12, following a strep infection such as strep throat or scarlet fever. It leads to a sudden onset of neuropsychiatric symptoms, including obsessive-compulsive behaviors, tics, mood swings, and changes in motor skills.

Here are some of the common symptoms of PANDAS:

• Obsessive-compulsive behaviors: This can include intrusive thoughts or the need to perform repetitive rituals, such as checking things multiple times or asking for constant reassurance.

• Tics: These are involuntary movements or sounds, similar to those seen in Tourette syndrome.

• Mood changes: This can manifest as rage, irritability, or extreme emotional shifts.

• Anxiety and depression: Increased separation anxiety, trouble sleeping, and a decreased appetite are also common.

• Difficulty focusing or learning: Some children may display ADHD-like behavior, including hyperactivity and challenges with focus.

The hallmark of PANDAS is that symptoms appear suddenly, often triggered by a strep infection, and occur in episodes. However, not every case fits neatly into this pattern. PANDAS can vary in severity and may present more subtly in some children.

What Causes PANDAS?

PANDAS occurs as a result of an autoimmune response triggered by a strep infection. The immune system, while attempting to fight the infection, mistakenly attacks parts of the brain, specifically the basal ganglia. The basal ganglia play a crucial role in motor control, emotional regulation, and behavior. When these areas of the brain are affected, it can lead to the behavioral and neurological symptoms associated with PANDAS.

A key mechanism behind this autoimmune reaction is molecular mimicry—a process where the strep bacteria mimic the body’s own healthy molecules. The immune system, recognizing these “mimicked” molecules as foreign, launches an attack on both the strep and the body’s own tissue, leading to inflammation and disruption in the brain.

Why Do Some Kids Get PANDAS and Others Don’t?

While strep throat is common, not every child will develop PANDAS. Factors that may increase susceptibility include:

• Chronic inflammation in the body

• Gut microbiome imbalances that disrupt the immune system

• A family history of autoimmune disease or rheumatic fever

• Frequent strep infections in the past

• Gender: Some research suggests that PANDAS may be more commonly diagnosed in males, though it may simply present differently in females, making it less recognized.

Testing for PANDAS

There is no single test that definitively diagnoses PANDAS. However, several tests can help piece together a diagnosis:

• Throat culture or rapid strep test: This confirms whether a strep infection is present.

• Anti-strep antibody test: This blood test measures the level of antibodies your child’s body is producing in response to a recent strep infection.

• Blood tests for inflammation markers (like CRP or ESR) and gut microbiome testing can provide additional insights into your child’s overall health.

At Revive Health, we believe in a comprehensive approach to diagnosis. In functional medicine, we often recommend a full assessment of your child’s immune system, gut health, and overall inflammation to get a complete picture of their health.

Addressing PANDAS Holistically

While conventional treatments often rely on antibiotics and symptom management with medication, functional medicine takes a whole-body approach to healing. Here’s how we can support your child’s recovery at Revive Health:

1. Nutritional Interventions:

• Anti-inflammatory diet: Remove processed foods, gluten, dairy, and sugar, all of which contribute to systemic inflammation.

• Support gut health: A balanced gut microbiome is essential for immune system function. Probiotics, prebiotics, and fermented foods can restore balance.

• Essential nutrients: Supplements like Omega-3s, Vitamin D, and Zinc can support brain function, reduce inflammation, and help regulate the immune system.

2. Healing the Gut: The gut-brain connection is crucial in autoimmune disorders. Since the majority of the immune system resides in the gut, rebalancing the microbiome is key to preventing future flare-ups. Probiotics, gut-healing supplements like L-glutamine, and anti-inflammatory herbs can help restore a healthy gut lining and improve immune function.

3. Reducing Inflammation: Incorporate anti-inflammatory herbs such as curcumin (turmeric), omega-3 fatty acids, and Chinese skullcap to help regulate the immune system and reduce inflammation in the brain and body.

4. Mind-Body Techniques: Cognitive-behavioral therapy (CBT), breathing exercises, mindfulness practices, and even equine therapy can help children manage the psychological and emotional impacts of PANDAS. These approaches, combined with physical activity, can balance mood and improve overall well-being.

5. Targeted Herbal Remedies: Certain herbs, like chamomile and passionflower, may help calm the nervous system. Additionally, berberine and oregano oil have antimicrobial properties and can assist in clearing infections without the negative effects of long-term antibiotic use.

6. Lifestyle Modifications: Encourage regular physical exercise to reduce stress, improve sleep, and support immune function. Mindfulness practices and adequate sleep are also vital for restoring balance to the nervous system.

Clearing Up PANDAS Myths

There are several misconceptions about PANDAS that can create confusion. Let’s address a few:

• Is PANDAS a “real” condition? Yes. Although it’s still controversial in some medical circles, the connection between strep infections and autoimmune neuropsychiatric reactions is supported by research.

• Does PANDAS always come on suddenly? Not necessarily. While many children experience sudden symptom onset, some cases are more gradual, especially in those with underlying immune system dysregulation.

• Can PANDAS occur without strep throat? Yes. Strep infections in other areas of the body, such as the skin, can also lead to PANDAS.

Restoring Balance to Heal PANDAS

PANDAS can be a challenging condition to navigate, but with a holistic, functional medicine approach that focuses on the whole person, it’s possible to restore balance and help your child thrive again. By addressing the immune system, gut health, and inflammation, we can support healing from the inside out—without relying solely on antibiotics or psychiatric medications.

At Revive Health & Wellness, we’re committed to helping families understand PANDAS and approach recovery with an integrative, whole-body strategy. If your child is struggling with PANDAS, don’t lose hope—there are ways to heal, restore balance, and set them on the path to a healthier future.

Start your child’s healing journey.

For more information on functional medicine treatments for PANDAS, connect with a Revive Advisor below.