Dr. Debby Hamilton

• PANDAS is linked specifically to strep infections.
• PANS is broader, encompassing multiple triggers beyond strep.

• Key symptoms and their overlap with other conditions, particularly autism, where underlying immune dysregulation can make diagnosis more challenging.
• Pathophysiology and clinical clues for identification.
• Common triggers.
• Diagnostic approaches.
• Treatment framework based on three pillars:
  1. Treat the infection.
  2. Modulate the immune system.
  3. Manage symptoms.

Differentiation of PANDAS vs PANS – PANDAS is strep-specific; PANS includes other infectious and non-infectious triggers.Abrupt Onset is a Hallmark – Sudden and severe behavioral or neurological change should prompt evaluation for PANS/PANDAS.
Immune System Misfiring – These are autoimmune brain disorders (basal ganglia encephalitis) where the immune system attacks healthy brain tissue.
Wide Range of Triggers – Beyond strep, triggers include bacterial, viral, fungal, tick-borne pathogens, toxins, and mold.
Complex Symptom Profile – Includes psychiatric, neurological, and physical symptoms, with possible overlap with autism and other chronic conditions.
Multi-layered Diagnosis – Lab testing should address infections, autoimmune markers, and immune function, but clinical judgment is key.
Treatment Requires a Multifaceted Approach – Simultaneously targeting infections, immune regulation, inflammation, and symptom relief yields better outcomes.
Herbal Medicine as a Versatile Tool – Herbal protocols can target multiple pathogens, modulate immunity, and reduce inflammation.
Importance of Gradual Introduction – Start with low doses to avoid strong die-off reactions and flares.
Symptom Support is Critical – Anxiety, insomnia, and behavioral symptoms require direct intervention to improve quality of life during recovery.

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