question about treatment of strep in child not diagnosed with PANDAS but with previous symptoms

[LiLi]

Hello,

 

First off, please forgive me if this is a question with an answer that is obvious to others, but not me.

 

A bit of background.....

 

My 7 year old and 4 year old had sore throats last year. They got better and then within a few days, they both developed VERY frequent facial tics. My 7 year old was "chattering" her teeth constantly (I counted over 100 once within 15 minutes). My youngest was blinking her eyes (and had quite sudden sensitivities to sensory issues e.g. the way her socks felt). They were very obvious "tics" with a very sudden onset in both of them. (I know tics as I have mild ones).

 

We went and had them swabbed and they both tested positive for strep so they both did a round of amoxicillin. (I was worried about PANDAS and freaking out about the tics). We also started magnesium supplementation. They tics went away in both of them (and sensitivities reduced in my youngest).

 

No major issues since.

 

Fast forward to right now and strep is going around again. My oldest has a very painful sore throat as of this morning. We are going to have it swabbed tomorrow at the doctor.

 

Obviously, I am hypersensitive to what CAN happen and PANDAS, etc. But my kids have only had that week long bout with any related symptoms. They haven't had issues since.

 

So my question is about treatment if this IS strep that she has (we will get the swab tomorrow).

 

Is it obvious that we want to treat it with antibiotics?

 

Or, can we let her try and fight it off on her own? Here's my reasoning: 1) I HATE doing antibiotics and am in the camp that feels that they wreck havoc on the gut, leading to all sorts of issues so we try to never do them, 2) I read somewhere that if they can fight it off on their own (if it's not too painful) they develop antibodies that makes it less likely to get repeated strep infections. And I really don't want to deal with this every year!

 

What's recommended for kids that "could be" at risk for PANDAS? Antibiotics right away? Is there research that shows treating it right away can prevent PANDAS from developing in the first place? Is there any research that shows there could be benefit to fighting it off without antibiotics?

 

Any thoughts/suggestions/advice is welcome and will be appreciated. I've grown up with tics (somewhat mild) and mild OCD so I know what's on the line here. I also am not sure if I'm over-reacting, given we haven't struggled with full fledged PANDAS as many have. Just that week of tics that followed a strep infection. Did we prevent it from getting worse by doing the antibiotics? Or did we make their bodies less able to fight it off themselves? Sigh. Help!

 

 

[qannie47]

If your children have demonstrated a positive relationship to Tics/Strep in the past, I would definitely treat with antibiotics if swab indicates Strep. Pandas is about a glitchy autoimmune system and misguided autoimmune cells. The abx will shut down the immune system as well as treat the infection, and that is what you want. Pandas is a chain of autoimmune events, the symptoms being the end result of an infection. That is why you do not always see the Pandas symptoms until days or weeks after an infection...

 

Hope this makes sense.

[ibcdbwc]

I agree with Qannie. It's better to quiet the hyperactive immune system reaction. That is not a chain that should be started. As their immune function matures, they will be better equipped to handle this - but for now - with a previous strep/tic correlation, it's best to treat.

 

No published literature that I have seen says that outcome is better when treated early. However, Dr. L is due to release a study soon that seems to indicate this result. And anecdotally, in the PANDAS community, this seems to be the general thought. Those of us that were diagnosed late, have more problems (my son was at least 4 years late...).

[mama2alex]

I think strep should always be treated with abx, but especially if you've already seen an autoimmune reaction to it (tics and sensory issues). Definitely give them a good quality probiotic 2-3 hours away from the antibiotics to protect the gut.

 

I will respectfully disagree with quannie and ibcdbwc and say that when the body's immune system goes awry, as with PANDAS/PANS, I believe there's always an underlying cause. From years of dealing with this, talking to doctors and other parents, and reading reading reading, I think the most common root causes are Lyme and it's coinfections such as Bartonella and Babesia; chronic viruses such as HHV6, Epstein Barr, and coxsackies; mold toxicity, methylation issues, vaccine reactions, leaky gut, food/additive/dye allergies, and mycoplasma. You can read more about all of those on this forum. A combination of some or all of these issues wear the immune system down and cause it to become dysfunctional. I think if you can determine what the underlying causes are (usually it's more than one) and treat them, you can prevent this from escalating. And you might find answers for yourself in the process.