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Well, I am going to post on this forum, an article I am going to reference mentions autism, please no one get offended. My topic is OCD, which is the predominant symptom of PANS. Wish it was all cut and dry: Do A, B, C, D, and it's fixed. It has not been like that for us, and others here, so perhaps this might help someone. I found a paper written by Amy Yasko from 2002 (!) that references OCD, inflammation, strep infections, and mainly, excessive glutamate in the brain - addictive behavior, and OCD seems like addictive behavior to me. I won't begin to try and give a synopsis on a Yasko paper ;-) http://www.dramyyasko.com/wp-content/uploads/2011/08/The-Role-of-Excitotoxins-in-Autistic-Type-Behavior.pdf Here is a paper on excess glutamate and OCD written in 2012 from the International OCD foundation: http://www.ocfoundation.org/glutamate.aspx And, a list of high MSG/endotoxins foods that release glutamate: http://www.msgtruth.org/avoid.htm Ibuprofen is known to suppress glutamate. So, on a personal note: this completely fits my kid. NAC/n- acetylcystine modulates excess glutamate- several recent studies, especially for Trichotillomania supression- I realized my dd has been chewing Trident gum excessively all summer, like all day (aspartame) other high foods on the list - she started skin picking for the first time- PharmaNac stopped it. Then I stopped giving it. Then, she picked up Impetigo on her face- back to antibiotics- OCD has been ramping up all summer- bought some more NAC, going to supp vitamin K, she has always done well with taurine, threw out the gum! (yes, I know about Spry) I've tried to supp GABA in the past- disaster - so it's not as easy as that to re-balance. We do not have CBS or sulfur MTHFR- Anyway, find this all interesting- maybe it might apply to someone else for help.