PANS & PANDAS

"Did you know that PANS is suspected as a culprit in up to 25% of all pediatric OCD diagnoses? "
Signs and Symptoms

PANS/PANDAS can affect a wide range of areas from brain development to metabolic processes. The signs and symptoms that are commonly seen include obsessive-compulsive, motor tics, vocal tics, irritability, mood swings, focus or attention diminished, academic/cognitive difficulties, and loss of motor coordination. This may have occurred during the first years of life or later into the teenage years.  The one thing you know for sure is that there was a specific event: infection or adverse reaction.


What is PANS/PANDAS

PANS is an acronym for Pediatric Acute-Onset Neuropsychiatric Syndrome. PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. The main difference between the two is that PANDAS is explicitly identified using an ASO (antistreptolysin O) lab test that reveals an unresolved strep infection as the primary cause. PANS, on the other hand, may or may not have an identifiable infectious cause. From this point, we will use the term PANS to describe both of them.

While there may be an infectious organism or a specific event that triggers the development of PANS, the origin itself is immune based. An organism or chemical enters through the blood-brain barrier and the immune system does not like this and becomes overactive. During this period of overactivity, it becomes confused and actually starts labeling brain tissue as bad. The region attacked is predominantly the basal ganglia, which is a relay system responsible for regulating emotions, cognition, movement, sensory control, and much more.


Our Approach to Diagnostics and Testing

Our clinicians not only have an understanding of the brain but have extensive knowledge of the immune system. They understand how the immune system and brain interact. This understanding necessitates not only examining your immune health but to assess brain function as well. It is only when both of these systems are functioning optimally that the best results can occur.  

How We Evaluate Immune Health:
  • Autoimmune Markers
  • Food Sensitivity Testing to both cooked and uncooked foods
  • Inflammatory Marker Testing
  • Genetic Testing
  • Viral load Testing

Revive utilizes research-based diagnostics to evaluate function in specific areas of the brain. Looking at eye movements, motor function, sensory function, cranial nerves, cognitive function, balance, and gait. This information allows us to better understand what areas are affected so we can develop a treatment plan that targets those regions and networks to make them stronger and more efficient. These tests include eye movements, motor function analysis, physical exam, cognitive ability and balance.  

  • The VGN or testing of eye movement gives us a representation of the function of eye muscles, cranial nerves, brainstem nuclei, cerebellum and cortical regions. By measuring things like gaze stabilization,  smooth pursuits, saccades, and optogenetics it helps us to differentiate the areas of weakness.

  • Motor function analysis enables us to see the strength, tone, and coordination of the movement of muscle groups so we can better understand the regions and networks of involvement. Networks that are utilized in movement are the coordination of movement involve the frontal lobes, parietal lobes, and the cerebellum.   

  • In our office, the physical examination is focused on not only finding definitive signs of functional deficits but also catching the subtle changes which give us greater insight into the physiology and function (these findings are often considered irrelevant or ‘within normal limits’ in most conventional clinical settings).  

  • Cognitive testing is utilized as a baseline marker to measure and monitor patient outcomes. These quantifiable tests validate results in many different avenues. Our testing encompasses depression screening, anxiety screening, verbal memory, psychomotor speed, processing speed, simple attention, and motor speed.  

  • Balance test or vestibular testing gives us an insight into the function of networks that are needed for standing, walking, even riding in a car. We look at the three main factors of balance (Vestibular, proprioception, and vision) both together and individually to isolate the areas of involvement.  



Our Approach to Care

At Revive we specialize in providing treatment to the immune system followed by neurological rehabilitation. Your treatment may include antibiotics, IVIG, supplementation, followed by brain stimulation; such as sensory-motor integration, repetitive transcranial magnetic stimulation (rTMS), hyperbaric oxygen, and rotational therapy.

We offer a unique process that is built to maximize time and results. To reach your personal healthcare goals, it is imperative that your physicians and care providers precisely know your individual story and desires. Your individual goals are the focal point of the comprehensive treatment plan which is based off your exam, diagnostics, and lab results.  

Beyond the neurological system, there are many factors that can impact the presentation of PANS: the immune system, diet, sleep, and stress (to list a few). By integrating knowledge of the brain and influence of these factors, we are able to be very specific with targeted therapies which create lasting neurological changes. Your treatment plan is designed specifically for you and is not a protocol.

This plan is executed over 10-15 days. Patients see measurable improvement during their time in our office and continue to make gains once they leave. To help ensure success on your journey of healing, we create and define a plan for you when you go home. This plan may include sourcing local specialist for a safe and effective continuum of care. Our goal is to see each patient continue to build upon the initial results they achieved in our office.
 

Research behind our treatments

Rapid Transcranial Magnetic Stimulation (rTMS) sends a magnetic waveform through the skull that depolarizes the brain cells.  rTMS can be directed at specific regions of the cortex to cause activation of the neurons in the area.  





Hyperbaric Oxygen therapy has shown to increase oxygen saturation to tissues and increase the amount of stem cell production and circulation. This allows for the greatest potential for healing in the brain.



Function Movement exercises and whole body vibration have shown tremendous results in increasing strength and self-awareness while activating the cerebellum and areas of the parietal lobes.





We utilize E-stim in many different waveforms to increase strength, increase self-awareness, decrease spasticity, and active brainstem neurons. The following studies are studies of individual waveforms and how they can affect strength, spasticity and awareness.




Sensory Motor Integration (SMI) can help increase reaction time and motor skills. SMI is strongly researched in the world of developmental delays and can be adapted to affect many different disorders.



Cold Laser Therapy has shown increases mitochondria production in cells, helping to decrease inflammation and increase healthy cellular activity. When the cold laser is utilized as a transcranial (through the skull) therapy we see an increase in brain activation to the targeted areas.






Vestibular therapy is a very powerful tool in the world of neurological rehabilitation. When we look at brain development we see that movement drive brain growth and one of the most important areas for sensing movement is the vestibular system. When we utilize rotational therapy to active the vestibular system we see an increase in activating in several cortical regions.






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