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  • pandas-cover-cropped.pngYour Child Has Changed; Should You Consider PANDAS?

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jdude

Dilated pupils

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My PANDAS DS is 11 (diagnosed at 10). Lately,we've been having several behavioral issues (probably made worse by a steriod course he is on...both for his asthma and PANDAS), severe oppositional behavior, swearing at my DH (saying F-you, which if my DH had ever said to his dad would result in getting his ###### kicked, but thankfully he realizes this is due in part to his condition), repeated potty/body part talk. We're off from school this week, but when he is in school, he seems to be able to keep behaviors in check (thankfully). I noticed last night during a meltdown that his pupils were dilated. At times, he does have extreme sensisivity to light..he wants the blinds in the kitchen closed whenever he's eating. I mentioned the pupils to my husband and he thinks I'm nuts and everything is "PANDAS". I know other people have mentioned this with their kids. I was just curious what was up with this.

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I have seen the dilated pupils a few times but only during the big meltdowns where he ends up a crying mess on the floor. The light has been a big issue though. He refuses to turn lights on even when pouring a drink in the kitchen, sits in the dark in his room and will fight with me about turning on a light even when reading, complains about the sun when driving in car....

Edited by fightingmom

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Before we even knew our son had PANDAS/PITAND, he was experiencing extreme sensitivity to light. We were so concerned, I took him to an opthamologist for a complete eye exam. We experienced the same thing in the car, in the kitchen, etc. He now is extremely sensitive to sounds. For example, when I'm unloading the dishwasher, if I accidentally "clang" dishes together, or make noise with the untensils, this really bothers him. The senses are definitely affected by this disorder, just like with autistic children.

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My 2 1/2 year old son has dilated pupils frequently and is pretty sensitive to light. Mostly when we are in the car, and sometimes when we change his diaper and he is under a light. We are not sure if he has PANDAS/ PANS as he has not been tested yet. We did explain these symptoms to Dr.B who says it may be a mild case of it and started him on Augmentin. I can't say the light sensitivity has gotten any better, but I have noticed his pupils less dilated. Although his poor belly bugs him :(

 

When his pupils are dilated, I ask him to look at the light, and then they go down. Is this typical for PANS? I know when some kids are in exacerbation, they have dilated pupils.... but if they look at the sun or bright lights, do they normally go down in a PANDAS kid?

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My son who is 9 has had dilated pupils and light sensitivity for years. We recently had him tested for PANDAS and Gus strep titers were elevated. It's interesting that seratonin causes pupil dilation. He's been on Prozac (which raises sersronon)  for several months but we are taking him off because his rage episodes have gotten so frequent. Seratonin seems to be an issue with him and sounds to be true for many PANDAS kids. He's been on meds for ADHD for years but now wondering if he instead has PANDAS and possibly a mood disorder. 

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Chances are that neither he nor most of our kids have 3 or more different "rare" things (ADHD, PANDAS, a mood disorder).  Much more likely is that he has one thing causing all the symptoms.  PANS/PANDAS can display like ADHD and mood disorder, and it also can produce dilated pupils, light sensitivity, and rages.  I would suspect PANS or PANDAS in your case.

About 1/3 of PANDAS kids are super sensitive to SSRI's like Prozac, so if your son is on a "normal" dose, his rages could be this kind of sensitivity.  Our own experience is that the sensitivity might change over the years.

Here is the paper that supports this sensitivity theory:
https://www.researchgate.net/publication/228785018_Selective_serotonin_reuptake_inhibitor-induced_behavioral_activation_in_the_PANDAS_subtype

Dr. Swedo also advocates for starting really low (like 1/10th normal dose) - I can give you a reference for that as well if you like.

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