If a child suddenly develops behavioral and neurological symptoms after a strep infection, PANDAS should be suspected. PANDAS is a neuro-immune disorder in which a strep infection triggers brain inflammation and the immune system starts to attack and destroy brain tissue, causing a sudden onset of neurological symptoms.

PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.

PANS, or Pediatric Acute-Onset Neuropsychiatric Syndrome, is similar, except environmental factors or other infections trigger symptoms.

PANDAS diagnosis criteria

• Significant obsessions, compulsions, tics
• Abrupt onset of symptoms or relapsing and remitting symptom severity
• Onset prior to puberty
• Association with strep infection
• Association with neuropsychiatric symptoms, including PANS symptoms
• PANS diagnosis criteria:
• Abrupt, dramatic onset of OCD or severely limited food intake and the addition of at least two of the following:
• Anxiety
• Emotional swings and/or depression
• Irritability, anger, oppositional behavior
• Regression
• School performance deteriorates
• Sensory or motor abnormalities
• Sleep disturbances, urinary frequency, bed wetting

Functional neurology help for PANDAS/PANS

Because PANDAS and PANS involve the immune system, management involves testing markers for inflammation, infections, immune function, and brain autoimmunity (when the immune system attacks and destroys brain tissue).

It’s also helpful to conduct a functional neurology exam to identify compromised areas of the brain, as well as to establish a baseline of brain function.

Repeat testing can show you how well PANDAS/PANS protocols are working. Functional neurology rehabilitation may also help with recovery. For instance, therapies targeting different areas of the brain can calm an over active immune system and over activation of pathways.

Functional medicine help for PANDAS/PANS

Additionally, functional medicine strategies may include removing inflammatory triggers from the diet and the environment; nutritional therapies to lower inflammation and support brain health; addressing blood sugar, gut health, and toxicity; supporting neurotransmitters; and repairing mitochondrial function and the blood-brain barrier.

Conventional medical help for PANDAS/PANS

Therapies from the conventional model that have been shown to help include steroids and NSAIDs for inflammation; plasmapharesis (plasma exchange) to reduce antibodies; intravenous immunoglobulins (IVIG) to support immune modulation; and immune modulating medications when necessary.

Understanding the PANDAS/PANS brain

When PANDAS/PANS strikes a child — an estimated 1 in 200 children are affected — parents become both frightened and devastated. Understanding what is happening in the brain can help alleviate anxiety.

The functional neurology exam can help identify which pathways in the brain are affected. PANDAS/PANS typically affects communication loops between the basal ganglia, cerebellum, and frontal lobe.

Act quickly to address PANDAS/PANS

PANDAS/PANS is a significant and scary disorder, but taking action quickly improves the chances of an optimal outcome. For more information, contact my office.

More than one in seven children suffer from developmental disorders today. But this doesn’t mean change isn’t possible. The brain is enormously malleable, or plastic, and with the right input on a consistent basis using functional neurology, we often can improve brain function.

Common brain development disorders today include:

• Attention deficit disorder (ADD)
• Attention deficit/hyperactivity disorder (ADHD)
• Asperger’s syndrome
• Autism
• Developmental coordination disorder (DCD)
• Nonverbal learning disability (NLD)
• Obsessive-compulsive disorder (OCD)
• Oppositional defiant disorder (ODD)
• Pervasive developmental disorder (PDD)
• Tourette’s syndrome
• Chronic allergies, asthma, eczema, digestive disorders

How brain development disorders arise

These disorders can arise for a variety of reasons, such as:

• Environmental toxins interfere with normal brain development.
• A viral or bacterial infection interferes with brain development.
• The child has an autoimmune reaction against neurological tissue that prevents normal brain development and function. This can be passed on in utero from the mother or develop in early life due to an environmental, viral, bacterial, or even dietary trigger.

Poor brain development unfolds in a variety of ways. For instance, important milestones in brain development, such as crawling, may be skipped. The brain is a highly complex network of multiple pathways. Proper formation of this network of pathways depends in part on the child going through each milestone of development.

When the brain fails to develop correctly, one hemisphere grows more slowly than the other, giving rise to various disorders that are either left-brain dominant or right-brain dominant. This is why we see kids who are intellectually advanced (left brain) yet socially and emotionally delayed (right brain). As this imbalance progresses, the brain finds it increasingly difficult to network between the hemispheres, causing loss of function.

Also, infections and autoimmune attacks against areas of the brain sabotage proper development and hinder function in those pathways. For instance, the basal ganglia, which helps regulate involuntary motor movements, is a common site of viral and autoimmune attack. This can cause disorders such as OCD, Tourette syndrome, and tics.

Start with metabolic health of the brain

Functional neurology also includes addressing the metabolic health of the brain. If the brain is struggling with inflammation, blood sugar imbalances, or chronic poor health from a bad diet, it will not respond as well to rehabilitation. Additionally, children’s brains require ample healthy fatty acids — EPA and DHA.

Metabolic issues to look out for with brain development disorders include:

• Inflammatory foods (sugars and junk foods) and food intolerances
• Chemical sensitivities
• Chronic infections — bacterial, fungal, or viral
• Digestive issues and leaky gut
• Autoimmune disease (when the immune system attacks and destroys tissue in the body, which can include the brain)

Functional neurology brain exercises for brain development disorders

Fortunately, functional neurology can help address brain development disorders.

The types of brain rehabilitation a child needs depends on patient history and a functional neurology examination, which assesses brain function, areas of under and over development, and areas that are over stimulated or under stimulated. The functional neurologist can then tailor exercises to the brain environment and adjust them over time as function improves.

Many families report swift and significant shifts in behavior, mood, sociability, learning, and other brain-based signs.

Ask my office how functional neurology can help if your child has a brain based developmental disorder.

Did you know too much iron is toxic and inflammatory? If you are working to manage a chronic inflammatory condition, make sure high iron levels aren’t sabotaging your efforts. (Likewise, low iron levels can also make it difficult or impossible to heal.)

Hemochromatosis is a genetic disorder in which the body absorbs too much dietary iron. It is a relatively common condition, affecting approximately a million people in the United States. Symptoms typically include joint pain, chronic fatigue, heart flutters, and abdominal pain. Untreated hemochromatosis increases the risk of diabetes, arthritis, liver inflammation (cirrhosis), sexual dysfunction, and other diseases.

Psychological symptoms may include depression, anxiety, nervous tics, and obsessive compulsive disorder. Iron accumulation in the basal ganglia of the brain can interfere significantly with neurological functioning, leading to movement disorders and/or dementia.

Because symptoms vary so much and the disorder is associated with differing conditions, hemochromatosis often goes undiagnosed. If hemochromatosis is suspected, a series of three blood tests known collectively as the Iron Panel confirm diagnosis.

Once hemochromatosis has been identified, it can be addressed in two ways. The medical treatment for hemochromatosis is phlebotomy, which means periodically drawing blood from the body. This helps normalize the body’s iron levels and can relieve many, though not all, hemochromatosis symptoms.

The other way to alleviate symptoms and reduce the dangers of hemochromatosis is through diet — avoiding certain foods and supplements, while favoring others.

What to Avoid

Don’t take iron supplements or multivitamins that contain iron. Even people who have not been diagnosed with hemochromatosis should be cautious of iron supplements (many different factors besides iron deficiency cause anemia, find the root cause for your anemia before taking iron).

Certain medical conditions, such as restless leg syndrome, are associated with iron deficiency, and iron supplements may be prescribed or recommended for these conditions. However, anyone should have their iron levels checked first before taking supplements.

Stay away from vitamin C supplements and orange juice, as vitamin C increases iron absorption. (It is generally okay, however, to eat whole foods that contain vitamin C.)

Avoid or at least minimize alcohol consumption. Alcohol compromises liver function, the organ most vulnerable to too much iron.

Stay away from shellfish and raw fish as they may contain infectious bacteria that people with hemochromatosis are particularly vulnerable to.

Avoid or minimize red meat consumption. Red meat contains a form of iron that the body absorbs most easily.

Avoid or minimize sugar intake. Sugar increases iron absorption.

What to Increase

Essentially, there are two types of foods that a person with hemochromatosis should eat plenty of.

The first category is foods that inhibit iron absorption, such as:

• Green or black tea
• Raw kale
• Eggs
• Legumes
• Foods rich in calcium, magnesium, polyphenols, tannins, phylates and/or oxalates.

The second category is foods that contain iron, but in a form difficult to absorb. Nearly all vegetables, fruits, whole grains, nuts, and beans are in this category. Many of them contain oxalates as well, which reduce iron absorption.

If you are going to occasionally consume some foods that have easily absorbed iron, such as meat or sweets, combine them with foods that block iron absorption.

A hemochromatosis diet need not necessarily be overly strict. Much of it will depend on an individual’s level of iron overload, as revealed by lab tests. Ask my office for more information on hemochromatosis and whether it may be hindering your functional medicine protocol.