Overview
PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) are clinical syndromes in which sudden-onset neuropsychiatric symptoms, most notably obsessive-compulsive behaviors and/or severe restricted eating, are triggered by an immune response to infection or inflammation. In susceptible children, the immune system produces antibodies that mistakenly target neuronal tissue in the brain, particularly within the basal ganglia, a region involved in movement, emotions, and behavior.
The resulting autoimmune-mediated neuroinflammation leads to dramatic and abrupt behavioral and cognitive changes, often appearing “overnight” and representing a striking deviation from the child’s prior functioning.
PANS is an umbrella diagnosis describing this acute neuropsychiatric onset from any trigger, including infections (e.g., streptococcus, Mycoplasma pneumoniae, Lyme disease, viruses), mold illness, metabolic disturbances, and psychosocial stress.
PANDAS is considered a subset of PANS specifically linked to Group A Streptococcal infections (e.g., strep throat, scarlet fever), featuring characteristic immune cross-reactivity known as molecular mimicry.
Both conditions are recognized as relapsing-remitting disorders, where new exposures or immune triggers can cause symptom flares. Without proper diagnosis and treatment addressing both the infection trigger and immune dysregulation, children may experience chronic impairment.
Common Symptoms
OCD / Severe Anxiety / Tics / Sensory Sensitivities / Separation Anxiety / Emotional Lability / Urinary Symptoms / Handwriting Decline / Regression of Developmental Skills
Root Causes & Triggers
01. PANDAS
→ Group A beta-hemolytic strep
02. PANS
→ Infections
● Lyme
● Babesia
● Bartonella
● Mycoplasma
● Coxsackie
● Retroviruses
● EBV
● SARS COV-2
→ Toxins
● Heavy Metals (mercury)
● Mold
● EMF
● Glyphosate
03. Nutrition
→ Low iron
● Makes symptoms worse
→ Low vitamin D
● Worsens neuroinflammation
→ Low b12
● Deficiency not causative but can amplify neuropsychiatric symptoms
Our Approach
Our approach understands that PANS/PANDAS is the body’s intelligent response to chronic dysregulation across the Four Pillars: circadian disruption, toxic burden, unresolved infections, and unprocessed trauma.
Effective treatment begins by identifying which of these key levers are most disrupted in your biology and unique health story using functional blood analysis, specific immune testing, Bioresoance and Autonomic Response Testing.
Once we uncover your unique levers we work in sequence to systematically bring the body back into a state of healing. We first restore circadian rhythm integrity to recalibrate hormonal, mitochondrial, and immune timing. We then open the drainage pathways to ensure the body can safely eliminate what has been overwhelming it. From there, we reduce toxic burden, systematically address stealth infections in the correct order and resolve the trauma patterns that keep the nervous system locked in defense mode.
Autoimmunity heals when the terrain heals. The goal is not immune suppression, but restoration creating an internal environment where inflammation is no longer required and the immune system can finally return to balance, clarity, and trust.
References
- Chang K, et al. Clinical evaluation of youth with pediatric acute-onset neuropsychiatric syndrome (PANS): recommendations from the 2013 PANS Consensus Conference. J Child Adolesc Psychopharmacol. 2015 Feb;25(1):3-13.
- Cooperstock MS, et al. Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part III-Treatment and Prevention of Infections. J Child Adolesc Psychopharmacol. 2017 Sep;27(7):594-606.
- Frankovich J, et al. Five youth with pediatric acute-onset neuropsychiatric syndrome of differing etiologies. J Child Adolesc Psychopharmacol. 2015 Feb;25(1):31-7.
- Pallanti S, Di Ponzio M. PANDAS/PANS in the COVID-19 Age: Autoimmunity and Epstein-Barr Virus Reactivation as Trigger Agents? Children (Basel). 2023 Mar 30;10(4):648.
- Greenberg R. Investigating the frequency of tick-borne infections in a case series of 37 youth diagnosed with pediatric bipolar disorder. Front Child Adolesc Psychiatry. 2025 Nov 6;4:1685016.
- Ratnaseelan AM, Tsilioni I, Theoharides TC. Effects of Mycotoxins on Neuropsychiatric Symptoms and Immune Processes. Clin Ther. 2018 Jun;40(6):903-917.
- Mojtaba Ehsanifar, Reihane Rajati, Akram Gholami, Joseph P Reiss. Mold and Mycotoxin Exposure and Brain Disorders. J. Integr. Neurosci. 2023, 22(6), 137.
- Gagliano A, Cat al. Pediatric Acute-Onset Neuropsychiatric Syndrome: Current Perspectives. Neuropsychiatr Dis Treat. 2023 May 24;19:1221-1250.
- Efe A. SARS-CoV-2/COVID-19 associated pediatric acute-onset neuropsychiatric syndrome a case report of female twin adolescents. Psychiatry Res Case Rep. 2022 Dec;1(2):100074.
- Pavone P, et al. SARS-CoV-2 related paediatric acute-onset neuropsychiatric syndrome. Lancet Child Adolesc Health. 2021 Jun;5(6):e19-e21.
Contents
The Autoimmune Revival Book
Inside the book, you’ll discover how modern science and embodied healing can work together to create sustainable vitality.
The Autoimmune Revival Free Course
The same breakthrough that saved my wife has now helped hundreds of patients break free from chronic fatigue, pain, and inflammation, naturally and permanently.
The Autoimmune Revival Book
Inside the book, you’ll discover how modern science and embodied healing can work together to create sustainable vitality.
The Autoimmune Revival Free Course
The same breakthrough that saved my wife has now helped hundreds of patients break free from chronic fatigue, pain, and inflammation, naturally and permanently.
