Expanding our Understanding of PANDAS and Introducing PANS: Microbe Influenced Immune-Behavior Dysfunction

For years many of use have been frustrated by a symptom cluster that looks for all intents to be PANDAS (see prior posts on this blog) and yet where there was NO streptococcus relationship. I recall a conversation with Dr. Sue Swedo, from NIMH several years ago.  Dr. Swedo was instrumental in framing our understanding of strep bacteria causing OCD behaviors.  At that meeting I asked her if they had data that other microbes caused PANDAS- like symptoms.  She was clear at that time that they had very little data to support other microbes in PANDAS. I have known Dr Swedo for a long time and always respected her willingness to buck the status quo.  She is a good clinician and a thoughtful researcher.

Clinically however, it was obvious something other than strep was causing strep-like PANDAS symptoms.  Enter now a new syndrome which fills that gap, PANS (Pediatric Acute-onset Neuropsychiatric Syndrome).  Just published is this article abstracted below.


Here are the accepted PANDAS criteria.


Here is what Dr. Swedo and colleagues from NIMH are proposing for PANS.


More importantly Swedo and colleagues paint a picture very similar to the historical and landmark observations of Dr. Doris Rapp.  Over a decade ago my foundation gave Doris (a longtime friend of mine) money to convert her archive of videos recording allergy reactions over to DVD to preserve her observations.  Please see: http://www.drrapp.com/ 

In Dr. Rapp’s work she observed allergies doing the same things that Dr. Swedo is now observing and calling PANS.  Let’s compare this from Swedo’s publication –


to what Doris Rapp MD presented two decades ago as reactions to a large variety of allergens and environmental exposures.


From: Is This Your Child? Doris Rapp, M.D. 1992

And furthering this parallel of observations between the two presentations evaluate these observations of allergy and PANS:


Swedo, et al 2012.


Rapp, 1992

In the Rapp example you can see food rapidly makes Andy crash and look also at the mood and behavioral changes demonstrated in his writing and drawings. Now go back and re-read the PANS category II criteria.

So I feel comfortable with the idea that in certain children, their brain is highly responsive and inappropriately reactive to minor immunological stimuli.

Think about how this influences your child and then I will talk more about this in a separate post.

About Dr Bradstreet
Dr Bradstreet is a graduate of the University of South Florida College of Medicine and received his residency training at Wilford Hall USAF Medical Center. He is a Fellow of the American Academy of Family Physicians. He is an Adjunct Professor at the Southwest College of Naturopathic Medicine in Arizona. He is extensively published in the peer-reviewed literature on subjects of autism, oxidative stress, mitochondrial disorders, virology, hyperbaric oxygen, and toxicology (especially heavy metal chelation). He is trained in the the isolation and use of stem cells.

9 Responses to Expanding our Understanding of PANDAS and Introducing PANS: Microbe Influenced Immune-Behavior Dysfunction

  1. roseann says:

    I see these types of acute “regressions” ( no ocd, but exhaustion,feeling “sick” all the time, emotional disconnection, loss of interest in friends, leaving the home becomes quite difficult, developmental slowing, sensory disregulation, defiance, lack of creativity) with viral loads and resulting brain inflammation. we cycle in and out of these. a regression can always be counted on in August when the light changes and we seem to recover to practically typical behavior by March. Huge fan of Dr. Rapp, her work was so validating for what my child was going through even after extensive treatment. PANS? thoughts?

    • I do think it is treatable. Whatever is happening with GcMAF the way I do it – seems to break this cycle.

      • Louise says:

        Can you elaborate a bit on this Dr. Bradstreet? When you say “treatable” do you mean that the autoimmune disorder can be healed? Also, this might be naive but what is “GcMAF”?

      • roseann says:

        thank you! GcMAF is on our radar. Microbe Influenced Immune-Behavior Dysfunction is a much better description for us than Autism at this point in the game, although a mouthful 😉

  2. edith says:

    That was a very interesting information, particularly when i saw how the food allergans affected the behaviors and mood. I deal with this similar situation with my son. When he consumes anything out of his diet or if there is a minimal food or environmental infraction but mostly food related , like a mirror the child becomes psychotic and agressive. It usually takes couple of days for him to calm down and be himself again.Therefore, i am trying to be so careful with him not to givie him anything that may cause reaction bc then he falls apart in front of our eyes. My hope is that one day his immune system will get stronger to overcome that. Meanwhle, i do everything possible to keep him out of these infractions. Would this be possibly be apart of PANDAS who knows.

  3. Jodi says:

    Our son also had issue’s with foods ( color/dye, aspertame and such) He has PANDAS & PDD-NOS. If our son has color/dye we notice a change in his behaviour within 20 min and it lasts up to 4 hours. I would love to know what that neutralizing dose is that you gave the child in the above example ? The other change we notice in our son is that prior to PANDAS he loved going on the trampoline and it helped him get back on task but since PANDAS the opposite is true. He goes off within a short time of being on the trampoline or swing – have you seen this in other children ? We give him advil when he goes off and this helps him within the same 20 min time frame- any thoughts ?

  4. Marissa says:

    I think there is so much that is not understood about this connection between viruses or bacteria and behavior. I remember about five years ago when we had been in our new house for about three weeks, my son contracted a virus with fever for a few days. As he recovered, he was just rotten for a while afterwards. Another time last year, just prior to coming down with a terrible stomach virus, my other son kept strangely wrinkling his upper lip and nose. And in February, my daughter was sick almost all month with colds and roseola with a high fever. After the roseola, she regressed behaviorally, became much more clingy, including having to sleep while touching my bare face, neck or shoulder, doing repetitive swiping of her mouth / chin area (like every two or three seconds) with nothing there to be seen. Some of these things seem to be self-healing, but I don’t buy the argument that these things are just the result of emotional trauma associated with being sick. My older son had what I believe was PANDAS with recurrent strep infections in the fall. He became very anxious, got nauseous and sometimes threw up in mornings before school, missed a lot of school, had repetitive burping, etc. No one (pediatrician, counselor, ENT) mentioned PANDAS or had heard of it when I mentioned it.

  5. Gabriella says:

    I write to you from Italy. My 6yo daughter who is HFA has been on the GFCF diet for 3 years. However we have seen greater gains since, due to a tooth infection, she was on ceftriaonxone. Her spontaneous language has improved attention and she is less hyperactive. We had the same effect/result with penniciline amd so, in her case, not just the strep bacteria affect her behaviour. Maybe, in the near future, her diagnosis could be PANS? What other treatments besides gcmaf would you suggest?

  6. Houck Family says:

    Dr Bradstreet can you tell us more about the PANS children taking GcMAF? Our child has PANDAS,but now I’m thinking its PANS.
    Our child’s writing and drawing looked like the messy picture when we did the “shots”, but resolved by the end of week,just in time for the next shot. It awoke his Panadas. So I ask
    Could it take longer for the immune system to figure out the shot is good and not a provoking invader when a child is under PANS?

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