Hi Gingermom,
I am by no means an expert. I have just started on this journey myself. Is your pediatrician informed about PANS/PANDAS? A few years ago I ended up finding a development pediatrician to manage my son's many medications due to OCD, ADHD, anxiety, and Tourettes. It wasn't until I consulted an OT for gross motor concerns that someone finally asked if my son had been evaluated for PANS/PANDAS. His history of Lyme and encephalitis at the age of 4 (now 10) and his current presenting diagnoses were her cause for suspicion. The dev pedi started him on ibuprofen every 6-8 hours and found a pediatric rheumatologist in our area for us to collaborate with. She ordered an incredibly long list of blood work and a urine sample. The impact on my son's behavior tends to be mild so it can be tricky to tell if the anti-inflammatories are working. That being said, baby talk and OCD symptoms are decreasing.
Take care ❤️