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My daughter has what was labeled a tic disoder last August but her new neurologist said she is very young for a tic disorder (2.5 years when it started) and he is thinking maybe a strep infection caused it. I cant remember if she was sick or not in the time before her tics started, there was a lot going on in our lives then. He is doing blood tests now but my question is, if it was almost a year ago that she had an infection can it be seen in her blood now??

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They may find some high titers- but, they won't be able to tell from how long ago the strep infection was. Titers may be normal, but that may be that they've already gone down if the infection was that long ago. Many times (and this is true for my child) the strep does not cause any symptoms that one would recognize as strep, as most only look for an immune response (fever, swollen tonsils) and not the behavioral response. For a PANDAS dx, you'd basically need to check for strep every times she has episodes of increased tics- its the temporal association between strep and behavioral exacerbations that indicates PANDAS. An actual autoimmune marker was never found. The autoimmune part of the PANDAS acronym is theoretical. I think in my daughter's case, it may be toxins produced by the bacteria themselves that are responsible for the behaviors.


One other thing- (this is my theory only) it seems that frequently PANDAS kids have high titers for a long time, and that's where its more likely(I think) to be an actual autoimmune problem, because the body continues making antibodies, even when the bacteria are gone, due to the fact that the immune system is sensing the antigens on the basal ganglia cells as though they were strep bacteria. My daughter seldom had high titers- only once, and they were not highly elevated. (even though we were positive that she'd had many strep infections, testing positive on the throat culture from the doctor's office.)


I don't care about the actual PANDAS dx anymore- she gets better on antibiotics, so as long as we can treat whatever it is appropriately, they can call it whatever they want.

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