OCD Linked to Strep Throat
Obsessive-Compulsive Disorder Symptoms May Develop After Infection
PANDAS, an acronym for the illness, can develop suddenly as symptoms of obsessive-compulsive disorder (OCD), Tourette's syndrome, or nervous tics after a strep infection.
Studies show that antibodies that are suppose to attack streptococcal infections mistakenly attack a brain enzyme and disrupt neuron interaction in children's brains. Researches at the National Institute of Health and collaborators at two universities have confirmed the likely method in which bacterial infections can trigger obsessive-compulsive disorder as well as symptoms of Tourette's syndrome and nervous tics.
PANDAS, short for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptoccocal Infections, occurs suddenly after a strep infection. Symptoms wax and wane but can reoccur with tenacity if a child develops another strep infection.
As children's fight off a strep infection, their immune systems create antibodies that will fight germs. Instead of targeting the strep bacteria, the antibodies will sometimes attack the part of the brain that controls movement. How the antibodies cross the blood-brain barrier is a mystery and still being studied.
Dr. Swedo of the National Institute of Mental Health, Drs. Kirvan and Snider at California State University and Dr. Cunningham of Oklahoma University reported in the July 2006 issue of Journal of Neuroimmunology that in their recent study, all patients with movement disorder had a higher level of the strep antibody that disrupts brain activity.
Symptoms of OCD include repeating behaviors (such as constant hand washing), dwelling on negative or irrational thoughts, and excessive worrying. Sudden, uncontrollable movements and irrepressible speech are associated with Tourette's and nervous tics.
Why do some children develop PANDAS after strep infections and other children do not? Swedo and other researches have shown that a specific antigen was significantly higher in individuals with clinical symptoms than in healthy children. Our immune systems detect antigens and develop antibodies to fight them off. The research indicates that there is a connection between the elevated antigens in PANDAS patients.
Much about PANDAS remains a mystery and research continues. Obsessive-Compulsive Disorder will often persist unrecognized as many patients tend to be secretive or embarrassed about their symptoms. Some children who have had multiple strep infections may demonstrate ongoing symptoms of OCD.
There is currently no test to determine PANDAS. Physicians rely on diagnostic evaluation for the disorder. The five criteria are:
• Presence of OCD and/or a tic disorder
• Pediatric onset (age 3 through puberty)
• Periodic course of symptom severity
• Association of group A Beta-hemolytic streptococcal infection, either a positive throat culture or history of Scarlet Fever
• Association of neurological abnormalities (movements, hyperactivity)
Because PANDAS is relatively new and still not fully understood, traditional treatment for OCD and other affected disorders are still considered best. New medications and therapies are being tested through clinical trials and studies.
Conventional treatment of Obsessive-Compulsive Disorder includes Cognitive Behavioral Therapy (CBT) and pharmacology. Some doctors will use nutritional supplements to compliment treatment. CBT uses imagery and other techniques to change distorted thoughts and perceptions. Medications can be prescribed in addition to CBT or sometimes alone. Different treatments work better for different children, but Cognitive-Behavioral Therapy seems to be the initial treatment of choice.
The sudden onset of OCD or movement disorder symptoms, especially after a strep infection, may indicate the need for evaluation by a physician.
For information on remedies and healing a sore throat, read Richards' article Home Remedies for a Sore Throat.
