Sensory Processing or PANDAs?

[IrishMom]

Hi all,

Our daughter finished a 2-wwek course of Augmentin earlier this month -- her first treatment for possible PANDAs after a bad virus in November led to severe issues (rage, ocd, tics, night terrors, extreme transition issues, etc). We've seen fantastic improvements since then. However, her biggest daily challenge now is transitions (i.e. putting on shoes/coat, going into school, leaving the classroom to go home, hopping into/out of cars -- she has been darting/running away, hitting/biting/needing to be carried when it's time to leave). Some of these issues were midly present before the virus, but we're trying to evaluate if this is all Sensory Processing Disorder or another PANDAs flare -- or combo of both. She starts weekly occupational therapy this week, fyi.

I'm wondering if anyone has been in the same position or has insights on trying to differentiate symptoms of SPD and PANDAS?

Thank you in advance -- Kelly

[MomWithOCDSon]

Kelly --

I suspect it is a combination of both...an unfortunate marriage of a genetic susceptibility and the PANDAS-related inflammatory response.  And it may not be a "flare" so much as a continuation of the original PANDAs/PANS immune onslaught; many of us find that a "typical" or shorter course of antibiotics is insufficient for fully addressing our kids' conditions, so a two-week course may not have fully addressed the "animal" that is PANDAS/PANs.

Our DS, too, had some mild sensory issues prior to a the full-blown PANDAs episode that sent us into a tailspin.  Once the PANDAs hit full force, we had him professionally evaluated and as with most of his behavior set, the results came back "borderline."  During PANDAs, he was alternately identified as "borderline" a number of things:  OCD, Asperger's, PDD-NOS, Sensory Processing Disorder.  You name it, the poor kid, at one point in time or another, wore a label for it.

What I can tell you is that, with the conclusion of effective PANDAs treatment, the sensory and social issues resolved 100%.  One doctor even took steps to revise his file to remove the former ASD notation he'd made there.

I would say, however, that I don't think you are wasting any effort in giving her access to OT; I think it will only help her as she heals and enforce positive behaviors and coping strategies that will stand her in good stead going forward.

All the best!

[O_Bear]

hi... our 8 year old son had two 10-day courses of antibiotics in October and  early November. It took a good four weeks post antibiotic, but he also has nearly returned to his pre-infection state. His psychologist said that quick onset and worsening (he always had mild transient tics) and the quick improvement of OCD/anxiety/ADHD/tics isn't the normal M.O. for those conditions. Like I said, we did two courses of antibiotics. He seemed to improve slightly after course one, but a re-test culture was positive for strep, though he didn't have a sore throat or wasn't "sick." While his focus is back, most ocd issues have resolved and his tics are gone, he has a few things that haven't resolved: periodic insomnia and a refusal to eat food with artificial colors or ingredients (that was an OCD thing that cropped up--at least he's cutting out bad stuff, right?). In his flare, he also had trouble transitioning and couldn't focus during transitions and would make a lot of noises during the time. I think his therapist really has helped him deal with this type of behavior and other OCD issues. At his worst, the therapy really wasn't effective, but on the ramp down, I believe it has been super beneficial. I hope that if he flares again that it will help lessen the severity of the adhd/ocd/TS. We've been seeing a CBT therapist weekly since the beginning of October.

I would ask for a follow up throat culture! Just to be sure.