PANDAS OCD Lab Test

Obsessive-Compulsive Disorder is a collection of thoughts and actions that come in to your mind without your desire or intention. They usually concern things that make no sense, or fears that have little real basis. They keep replaying, over and over, so that they cannot be shaken from your mind.

Whether it makes logical sense or not, the compulsion will reduce the anxiety for a brief amount of time; a child with OCD believes that unless he does things a certain way, something bad will happen. But over time his brain builds up a "tolerance" to the rituals’ calming effects, and he then has to develop more and more elaborate rituals to get relief from the obsession. With so much anxiety and time consumed by OCD, children are rushed to complete their daily tasks, and, therefore, are even more stressed.

Pediatric Autoimmune Neuropsychiatric Disorder Associated with Group A Streptococcal Infection (PANDAS)

Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) has been described in children with Obsessive-Compulsive Disorder (OCD) Anorexia Nervosa and/or tic disorders subsequent to streptococcal infections. The acronym PANDAS has been given to a subgroup of pediatric patients who meet five inclusionary criteria:

1. Presence of OCD and/or onset of tic disorder
2. Pre-pubertal symptoms onset
3. Sudden onset or episodic course of symptoms
4. Temporal association between streptococcal infections and neuropsychiatric symptoms exacerbation
5. Associated neurological abnormalities including anti-neural antibodies and neuroimmune dysfunction

How does Autoimmune OCD (PANDAS) differ from Non-Autoimmune OCD?

The symptoms of the two conditions are indistinguishable, but by examining the course of the two diseases one may be able to differentiate the two.

1. Non-autoimmune OCD has a gradual on set, with signs for months or even years before the symptoms become dysfunctional. In contrast, the autoimmune OCD (PANDAS) episodes develop rapidly. Overnight, the changes are dramatical. Parents of children with PANDAS describe the sedramatical changes as if their child had gone to bed one night and had awakened as a completely different person who was hard to recognize.
   
   

2. A second distinction is the way symptoms progress. The pattern of OCD symptoms in PANDAS is characterized by sharp ups and downs, which may correlate with the rise and fall of antibody titers against strep antigens and their cross-reaction with B-cell antigens and basal ganglia. In children with non-autoimmune OCD the ups and downs are not sharp and are more gradual. The symptoms come and go, but without acute exacerbation.
   
   

3. A third feature of PANDAS is the association of the symptoms that come with episodes. Children may havetics, trembling, twitches, grimacing, clumsiness, loss of math skills, sensitivity to touching and clothing tags, poor attention span, distractibility, irritability, impulsivity, separation anxiety and bedtime fears. The following guidelines are recommended by NIMH and summarized by Dr. T. E. Chanskyin her book, "Freeing Your Child From Obsessive-Compulsive Disorder." The book will help you to become knowledgeable about the signs and symptoms of PANDAS, as well as the steps to take if you suspect your child or your patient has PANDAS:

Signs and symptoms of Autoimmune OCD (PANDAS) 

• Sudden onset or sharp increase in OCD symptoms
• Presence of tics and/or hyperactivity Involuntary and irregular movements of the legs, arms or face
• Irritability, temper tantrums, mood liability
• Age regression: reverting to younger developmental stage
• Separation anxiety
• Nighttime difficulties
• Severe nightmares and new bedtime fears or rituals