Lyme Disease and PANS: Pediatric Acute-Onset Neuropsychiatric Syndrome
Pediatric acute-onset neuropsychiatric syndrome, also called PANS, is the sudden development of OCD, anxiety, mood disorders and attention issues as a result of an infection. In the case of PANS the infection causes an autoimmune response in the neurological system that leads to neuropsychiatric symptoms. It is also referred to as autoimmune encephalitis. There are multiple infectious agents, both viral and bacterial, that are associated the onset of PANS. One of the infections identified as a trigger for PANS is Borrelia burgdorferi, the bacteria that causes Lyme disease.
The symptoms of Lyme disease and PANS are very similar. There are a number of neuropsychiatric symptoms associated with Lyme disease and co-infections. As early as 1998 a case of Lyme disease presenting as Tourette’s in a young boy was published by Riedel et al. Bransfield (2018) reports the following:
“An outpatient retrospective chart review without a control group demonstrated 80% of children with psychiatric illness referred to a child psychiatrist, 49 of the 69 without a known history of Lyme borreliosis or other tick-borne disease, demonstrated evidence of exposure to one or more of the pathogens B. burgdorferi, Bartonella, Babesia, Ehrlichia and Anaplasma on serologic testing performed by multiple laboratories.”
PANS is a clinical diagnosis that is based on a specific presentation of symptoms. However a diagnosis of PANS doesn’t help to identify what infection was the underlying trigger for the autoimmune response. In order to effectively treat PANS it is important to identify the infection that is the causative agent. Testing for Lyme disease and co-infections is important in PANS patients.
When dealing with a child with PANS or sudden onset neuropsychiatric symptoms it is recommended that Lyme disease is tested for and treated appropriately. Treatment for both Lyme disease and PANS requires therapies that help to modulate and retrain the immune system. These chronic conditions can create chaos within the immune system and a holistic approach is often required to help restore balance. Naturopathic medicine offers a number of options to patient’s with these conditions to help modulate the immune system and heal the brain to restore health in kids affected by Lyme disease or PANS.