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PANDAS: Coming To A Diagnosis May Be A Long Path
Not every doctor will have seen PANDAS before, and even those who have may be reluctant to diagnose it even if the symptomatic picture fits. In this day and age, it isn't rare for parents to explore the possible causes of their child's symptoms online. It can happen that you suspect PANDAS before your doctor does. What should you do if your doctor doesn't want to consider the diagnosis of PANDAS, but you are pretty convinced that it is an option? Seeking a second opinion is a good course of action here. Some parents specifically contact the PANDAS Network to look for a doctor who has experience with the syndrome, and you can also look for local doctors who have dealt with PANDAS before via the internet.
Treatment options depend on whether the strep infection is still present or not. If a strep throat culture comes back positive, the appropriate antibiotics will cure the infection, often allowing symptoms to wane pretty quickly by themselves. Where a throat culture is negative, clinicians should look for occult strep infections, like those present within the sinus.
Once the strep infection is gone, the neuropsychiatric symptoms associated with PANDAS may still persist. While some parents report that the symptoms of PANDAS improve almost immediately after a course of antibiotics, and others notice a gradual improvement with time, some children continue to suffer with OCD symptoms, tics, and other related behaviors.
Because symptoms may persist, children diagnosed with PANDAS will often benefit from Cognitive Behavioral Therapy to tackle their OCD symptoms. SSRIs may also help here, but the recommendation is to start at low doses due to possible side effects. As for tics, those can be treated medicinally as well.