PANS/PANDAS: What Every Parent Needs to Know About These Misunderstood Autoimmune Brain Disorders

When a child suddenly develops obsessive behaviors, tics, regression in handwriting, or extreme anxiety, most parents and doctors look for psychological explanations. But what if these dramatic behavioral changes are actually caused by an immune system attacking the brain?

In a groundbreaking interview with The Holistic Kids' Show, our Chief Medical Officer and Co-Founder, Dr. Zendi Moldenhauer had the opportunity to explain PANS/PANDAS - conditions that remain widely misunderstood and misdiagnosed despite affecting 1 in 200 children.

What Are PANS and PANDAS? Understanding the Autoimmune Connection to Brain Health

PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) represent a paradigm shift in how we understand certain behavioral and neurological symptoms in children.

These conditions occur when the immune system, triggered by infections or environmental factors, mistakenly attacks the brain - specifically the basal ganglia region responsible for movement control and behavior regulation.

As Dr. Zendi explained to the young hosts of The Holistic Kids' Show, these conditions blur the traditional line between "psychiatric" and "medical" problems, highlighting the critical root cause that Functional Medicine practitioners have long recognized.

PANS/PANDAS Symptoms: Recognizing the Warning Signs Many Doctors Miss

The hallmark of these conditions is their dramatic and sometimes overnight onset. Parents frequently describe the experience as "my child suddenly changed" or "something took over my child." Common symptoms include:

Sudden onset of obsessive-compulsive behaviors
Severe separation anxiety or school refusal
Motor or vocal tics
Regression in handwriting or math skills
Urinary frequency or bedwetting
Food restrictions or sensory sensitivities
Emotional lability and rage episodes
Sleep disturbances
Physical symptoms like joint pain

What makes these conditions particularly challenging to identify is that they're often misdiagnosed as purely psychiatric issues like OCD, Tourette's, Anorexia, or generalized anxiety - leading to ineffective treatments that don't address the root cause.

PANS vs. PANDAS: Key Differences Parents Should Understand

During the podcast interview, Dr. Zendi explored the important distinctions between these related conditions:

PANDAS is specifically triggered by streptococcal infections (strep throat), with symptoms appearing or intensifying following these infections.

PANS is a broader diagnosis where the symptoms can be triggered by various infections (Lyme disease, mycoplasma, viruses) or environmental factors, not just strep.

Both conditions share similar neuropsychiatric symptoms, but understanding these differences is crucial for proper diagnosis and treatment approaches.

The Family Impact: How PANS/PANDAS Affects Siblings and the Household

One of the most touching moments in my conversation with The Holistic Kids' Show hosts was discussing how these conditions affect the entire family system.

Siblings of children with PANS/PANDAS often experience confusion, fear, and sometimes resentment as family resources and attention shift dramatically. They may struggle to understand why their brother or sister is suddenly behaving differently or receiving special accommodations.

For parents, the emotional toll is immense - from fighting for proper diagnosis to managing flare-ups, coordinating multiple specialists, and often facing financial strain from treatments not covered by insurance.

Functional Medicine Approaches to PANS/PANDAS: Treating Root Causes

At Arbor Health Functional Medicine & Psychiatry, our approach to PANS/PANDAS focuses on identifying and addressing the root causes rather than simply managing symptoms. This typically includes:

Identifying and treating underlying infections - whether strep, Lyme, mycoplasma, or other pathogens
Addressing immune system dysregulation through specialized testing and targeted interventions
Healing gut permeability issues that contribute to systemic inflammation
Reducing overall inflammatory burden through dietary modifications and environmental changes
Supporting the brain's natural healing mechanisms with targeted nutrients and therapies

This comprehensive approach has helped countless children reclaim their lives and return to their true selves.

Practical Strategies for Parents: Managing PANS/PANDAS Flare-Ups at Home

During the podcast, I offered practical advice for parents dealing with symptom flare-ups:

Create a calm, predictable environment - Reduce sensory stimulation during flares
Implement gentle but consistent routines - Structure helps children feel safe while their brain is inflamed
Practice extreme self-compassion - Remember that behavioral symptoms are not willful or disciplinary issues
Document patterns and triggers - Keep a symptom journal to identify patterns and potential triggers
Build a support network - Connect with other PANS/PANDAS families and supportive healthcare providers

These strategies don't replace medical treatment but can significantly improve quality of life during the healing journey.

The Diagnostic Journey: Why PANS/PANDAS Are Often Missed by Conventional Medicine

One of the most significant barriers families face is getting a proper diagnosis. Traditional medical training often compartmentalizes the body's systems, making it difficult for practitioners to recognize connections between immune function and neuropsychiatric symptoms.

Comprehensive testing is required to identify and treat the root cause. Potential root causes include:

Autoimmunity
Genetic predispositions
Gut health imbalances
Heavy metal/toxin load
Infections
Mold exposure
Nutritional deficiencies
Systemic inflammation

At Arbor Health, we examine these markers alongside detailed patient histories to identify patterns that conventional approaches might miss.

Hope for Recovery: Real Possibilities for Children with PANS/PANDAS

Perhaps the most important message I shared on The Holistic Kids' Show is that recovery is possible. When properly diagnosed and treated, many children with PANS/PANDAS experience dramatic improvement and often full resolution of symptoms.

The key factors for successful outcomes include:

Early identification and intervention
Comprehensive treatment of root causes
Ongoing immune support
Family education and support
A multidisciplinary treatment team

Listen to the Full PANS/PANDAS Interview: Expert Insights from Dr. Zendi Moldenhauer

This Holistic Kids' Show episode offers invaluable information for any parent concerned about sudden behavioral changes in their child. Key timestamps include:

[04:37] What are PANS/PANDAS?
[08:19] Common symptoms to recognize
[11:11] The child's emotional experience
[12:00] Effects on siblings and family
[14:07] Differences between PANS and PANDAS
[15:08] Strategies for difficult days
[20:13] Guidance for parents when symptoms worsen

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About Dr. Zendi Moldenhauer

Dr. Zendi Moldenhauer, PhD, NPP, PNP, RN-BC, IFMCP, is the Co-Founder and Chief Medical Officer at Arbor Health Functional Medicine & Psychiatry. With over 25 years of experience treating mental health, she specializes in identifying root causes of complex neuropsychiatric conditions in children. Her pioneering work in brain health and the gut-brain axis has transformed many children's lives, establishing her as a respected leader in the field.

This Website has been created to provide information about functional health care services and is for general informational purposes regarding functional health care that should never be construed as medical advice for any person, including patients of the Practice. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Source:

2018 PANDAS Network Survey https://pandasnetwork.org/