Who Inspires a PANDAS Researcher?

So who inspired one of the most influential people in the PANDAS research community to become a researcher? Read Bio Matters: A father’s love of science sparked research career for OU professor and find out why Dr. Madeleine Cunningham began her decades long career studying strep, Rheumatic Fever, and now PANDAS.

Dr Madeleine Cunningham
When Madeleine Cunningham was a child growing up in Mississippi, her father drove her through the Southern forests and explained his work as a botanist and forestry expert.

“He used to show me all of his experiments with trees,” Cunningham said. “He would talk about their genetics. He just had a great interest in science.”

That love of science was transferred from father to daughter.

 

Read the entire article at http://newsok.com/bio-matters-a-fathers-love-of-science-sparked-research-career-for-ou-professor/article/4888862/?page=1.

NE Conference Highlights

PANDAS Network Table

 UPDATED 12/9/2013 to include additional notes.

November 9 and 10 proved to be a well informed and uniting day for parents, researchers, and physicians. With over 400 people in attendance, this was the largest conference solely devoted to PANDAS and PANS. Thank you to the NE PANS/PANDAS Parents Association for their great work and to all those that presented and attended.

Below, you will find links to some of the presentations along with a compilation of notes taken by various people. Thank you to Vickie and Chrissy D.

 

Presentation Slides

Click to be brought to the presentation.

Swedo pdf 1

PDF #1 : http://tinyurl.com/swedopart1
PDF #2: http://tinyurl.com/swedopart2

Chapman pdfMicco pdf

 

 

 

Bock pdf


PDF #1: http://tinyurl.com/BockPANS1
PDF #2:http://tinyurl.com/BockPANS2

Hubbuch pdf

 

 

 

Presentation Highlights

Audience 2

 

Dr. Susan Swedo

General Information

  • It may be more appropriate to refer to PANDAS as a “misdirected immune response”.
  • If you cannot remember the onset, there is a chance it is not PANDAS.
  • Not all kids with OCD and tics have PANDAS
  • PANDAS may be created by the following: Strep > genetic susceptibility > misdirected immune response
  • An example of a case where on an MRI, the caudate size was less inflamed post treatment (by 20%)
  • Rule our Rheumatic Fever
  • Test for ANA (antinuclear antibodies)
  • SSRI- start low. 1/20 of the regular dose may be indicated for initial dosing
  • Affirm to children that only 1% of their brain is affected. The other 99% is healthy and working to help you heal.
  • Sleep studies are in the works
  • EEG may be something to look into with sleep abnormalities and may get you treatment.

Sydenham’s Chorea (SC)

  • 75% of kids with chorea have OCD
  • SC is a rule out for PANDAS. If you suspect PANDAS or cannot get a diagnosis, rule out the possibility of SC.
  • If you are able to get a diagnosis of SC, you will get a treatment plan.
  • Physicians need to taught the difference between chorea and choreiform movements.

Symptoms

  • PANDAS and PANS is not only OCD. Must have other symptoms present.
  • 80% of kids have urinary frequency. Make sure to mention this at pediatrician’s office. This will lead to testing including UTI. It may get a documented infection and treatment.

Strep

  • Don’t chase titers. Even with a treated infection, titers will naturally rise for a bit
  • 65% of kids will get strep during the school year.
  • You can test positive without classic symptoms. Stomach ache and headache can be the only symptoms of strep you get.
  • Strep is not the only trigger (PITAND)

PANS

  • H1N1 outbreak greatly increased number of PITAND cases
  • When developing PANS criteria, wanted to include post puberty individuals.
  • Restrictive eating – not necessarily anorexia, but some just cannot swallow. Feels odd. Swallowing study may be indicated.

 

Dr. Dritan Agalliu

General

  • TH17 immune cells is a normal immune response. If interrupted, erroneous events occur

Strep

  • Streptococcal specific immune cell entry introduced via the CNS is an unusual route
  • Subset of strep strains can become erroneous and create reactions
  • 20-30% of kids with RF will develop SC.

Blood Brain Barrier

  • How do antibodies get access to the brain?
  • The Blood Brain Barrier (BBB) is a physical barrier
  • BBB breakdown is known to occur in stroke, Acute Traumatic Brain Injury, brain infections, and autoimmune disease such as PANDAS and PANS.
  • Junctions that protect the brain can be damaged and destroyed

Collaboration with Dr. Pat Cleary

  • Researching the immune response to intranasal infection in mice.
  • Mice became sick with classic symptoms, but then resolved
  • After 3rd or 4th infection, classic symptoms no longer appeared
  • Repeated intranasal infections induced IL-17 immune t-cells in NALT (Nasopharynx-Associated Lymphoid Tissue). Side note: the IL-17 family has been linked to many immune/autoimmune related diseases

Research observations

  • T-cells were found in the brains of the mice. They did not know if that would actually occur.
  • OLFACTORY BULB part of the brain was most affected by the t-cells
  • Biocytin tracer was used to measure the defects of the BBB permeability.
  • Largest are affected was the area that controls a sense of fear.
  • To see what BBB damage occurred, looked for antibodies that were normally present—-they found auto-antibodies.
  • The bacterium itself (strep) was NOT found in the brain.
  • T-cells were present in the brain of the MOUSE for 58 days. In the life of a mouse, that is considered long term. What would that translate into human?
  • T-cells may stay in the brain and be reactivated with other infections.
  • T-cells start in the olfactory bulb and migrate
  • What are the long term side effects of a leaky BBB? Will the BBB remain susceptible?

 

Dr. Beth Latimer
  • Has seen over 2,500 patient with PANDAS
  • PANDAS is a tragedy due to lack of recognition
  • Has seen a few kids from IVIG study due to relapse from reinfection
  • When tics are the main symptoms, may be categorized as a “PANDAS variety” due to new diagnosing criteria.
  • Dr. Latimer shared numerous case studies during her presentation to show the varying forms of presentation and the spectrum of the disorder
  • General observation/question asked…Is PANDAS an early presentation of Autoimmune Encephalitis?
  • We need to look at why urinary frequency occurs in so many children.
  • Referred to the Rey-Osterrieth Complex Figure Test and how numerous PANDAS children fail this test. See the following paper for more information: http://neuro.psychiatryonline.org/article.aspx?articleid=181293
  • This does not appear to be the same strep that causes RF
  • IgG range tends to be lower part of normal
  • Low Vitamin D has been associated with autoimmune disease. Get Vitamin D levels checked – do this before giving supplements and at times throughout the year as levels will change with seasons.
  • If giving steroids, morning dosing is preferred, no later than 3pm. This will decrease the chance of affecting sleep.
  • Flonase observation: Is it really a good idea to suppress the immune system in the nasopharynx?
  • Gut flora: There is something different about the guts of PANDAS kids. They tend to be able to tolerate long term antibiotics very well even if not taking a probiotic.
  • Would not recommend naproxen sodium as a NSAID…way too rough on stomach.

 

Dr. Jan Tona

Current Retrospective Survey Being Conducted

  • http://pandasnetwork.org/survey/
  • 410 enrolled to date – minimum 500 wanted. May remain open until end of 2013.
  • Future research can collaborate and access the respondents for possible participation in future studies.

Past Research at Univ. of Buffalo

 

Dr. Kyle Williams
  • Spoke a bit on YALE-NIMH IVIG study
  • Primary outcome measurement was decrease in CY-BOCS a standardized tool to measure OCD severity
  • Double blind placebo controlled study; different researchers screening, present during infusion and doing post-analysis to blind reviewers
  • MRI pre/post treatment
  • Autoimmune antibody analysis pre/post treatment (Cunningham)
  • Inflammatory cytokine analysis pre/post treatment
  • Serum and CSF t-cell profile
  • Screened 1100 children with 37 participants—18 IVIG 17 placebo
  • In the analysis phase of trial and hope to be completed soon

 

Dr. Rosario Trifiletti
  • Narrow definition of PANS/PANDAS good for research but not in clinical practice. You don’t want to leave anybody out you could help.
  • ‘No child left behind’
  • Reviewed his different age stratifications of PANS and what you might see at different stages (‘autism, PDD, Swedo Syndrome, Kovacevic Syndrome, LeRoy Syndrome, Excorcist Syndrome’)
  • Touched upon his genetic testing  and emerging patterns/clusters of defects seen in PANS
  • Touched upon his alternate fever response and histamine dysfunction but didn’t have enough time for details

 

Dr. Kenneth Bock
  • Talked on integrative approach to neuro-immune disorders/PANS/PANDAS
  • Discussed Immune Balance – a balanced cellular and humoral response
  • Importance of gut health in immune disorders—75% of immune cells found in the gut
  • Important to deal with the underlying factors that contribute to recurrent infections/autoimmunity and chronic inflammation
    • Toxins/heavy metals
    • GI issues: dysbiosis/intestinal hyper-permeability/food allergies and sensitivity
    • Environmental allergies and sensitivities
    • Nutritional imbalances and deficiency
    • Hormonal and immunological imbalances
  • FIRST TACKS law – “if you are sitting on a tack; it takes a lot of Risperdal to make it feel better. The appropriate treatment for tack sitting is tack removal.”
  • SECOND TACKS law—“if you are sitting on two tacks, removing one does not produce a 50% improvement. Chronic illness is, or becomes multifactorial.” Adapted Sidney Baker
  • Talked on the immune threshold – illustration of a kettle with layers influencing immunity—genetic predisposition, nutritional deficiencies, allergies and sensitivities; environmental toxins, psychosocial stress etc. Then showed adding infectious agents and kettle spilling over due to immune imbalance.
    • Discussed dietary modification as anti-inflammatory therapy
    • Mentioned caution w/ NSAIDS as contributes to leaky gut
    • “Leaky gut leaky brain” was his takeaway lesson
  • Treatments (in addition to traditional therapies):
    • Treatment w/ Omega 3 fatty acids to decrease inflammation
    • Curcumin
    • methylB12 – neuroprotective effect and enhances methylation
    • vitamin D3 –and immunoregulative function
    • probiotics & prebiotics
    • exercise/ tai chi
    • talked on Candida/yeast—how a big trigger for many of our kids; leading to dysbiosis; importance of yeast’s  role in dysregulation of immune response.

 

Dr. Jolan Walter—MASS General Hospital
  • Will be part of team at new Mass General – she is allergist/immunologist
  • Neurobehavioral and immunology clinic (not calling it a PANDAS clinic)
  • Treating with IVIG – sometimes multiple doses—replacement dose is 0.5gm/kg; anti-inflammatory dose 1.5/2gm/kg
  • Over 50% of IVIG products use is off label in medicine
  • Using Rituximab for refractory cases—it targets B cells—is also used in RA and autoimmune disorders (off label) – not used in “typical cases”, very extreme and difficult to heal cases.

 

Dr. Jamie Micco
  • Talked about the use of CBT (cognitive behavioral therapy) in PANDAS OCD
  • Families may unwittingly provide excessive accommodation and reassurance for child’s compulsions and rituals, which feeds into behavior
  • Cognitive training—think of obsessions as ‘spam messages’
  • Developing fear and avoidance hierarchies and working through situations from least amount of fear to most fearful (ex. Start by exposing child to least fearful situation and work up)
  • Not much research on CBT for PANDAS subtype of OCD—only Dr. Storch
  • Don’t embark upon CBT at the height of symptom exacerbation, b/c children may be too dysregulated
  • Booster sessions important for PANDAS children, given their risk for relapse

 

Peggy Chapman, CNS
  • Talked on psychiatric management and behavioral interventions in children with PANS
  • Slides explain in detail her talk—she started on how to explain PANS to your child
  • Recommended naming your PANS—give it a name, code word
  • Ride out the flares—scary but they usually only last a week
  • Behavioral interventions
  • Anxiety attack—in PANS it’s neurological—reasoning doesn’t work in the heat of the moment
  • PANS children with OCD usually cannot talk about or describe their OCD in office, unlike traditional OCD
  • Helpful maneuvers—empathy, normalizing, validating & making manageable
  • Total meltdown attack—stay calm & reassuring; don’t try to fix problem with minimal conversation; stay with kid but not too close
  • OCD—not becoming an unwitting accomplice
  • Rule of 3: participate 3 times then you’re out; time rules to re-engage in OCD again
  • Readiness for CBT—need to be stabilized first
  • Tics—if you bring attention to the tic there will be an increase
  • “tics can be suppressed but not denied”
  • Reviewed neurotransmitters and then went through different classes and names of drugs that might be used

 

Dr Jeanne Hubbuch
  • Ticks carry multiple infections – nature’s ‘dirty needle’
  • Lyme disease must include borrelia and co-infections
  • Lyme can occur any time of year, and in any region of the US and Canada
  • Transmission can occur within 4 hours—no safe time of attachment
  • PREVENTION—spray yard with permethrin; cut down shrubbery; low grass; clear under trees; body checks; DEET (not infants); oil of lemon and eucalyptus
  • Tick tubes (Damminix) can decrease larvae/tick population
  • To send away ticks and test for disease  http://www.tickdiseases.org/
  • Ticks also carry anaplasma, ehrlichea; babesia, bartonella, mycop, viruses

Diagnosis

  • Lyme Disease is a clinical diagnosis
  • Early diagnosis—tick bite and symptoms
  • EM rash is definitive with or without tick or labs
  • Lyme disease is great imitator
  • All organs can be affected and symptoms often vague

CDC testing

  • Elisa 50% false negative
  • Western Blot—CDC def 2 IgM bands/5 IgG bands
  • Band 41—non-specific
  • Lyme specific bands—18, 23, 31, 34, 39, 83-93
  • Igenex tests all bands including 31 and 34
  • Advanced Lab at 16 weeks 94% accurate but only one peer-reviewed article to support
  • CD57 test—more accurate for adults; sign of chronic disease; lower result sicker person

Treatment

  • Early—4 weeks; amoxi; ceftin; doxy if >8 years old
  • 30% can have neg western blot
  • Biofilms can make treatment difficult
  • Co-infections – sicker
  • Antibiotics—cell wall agents; intracellular agents; cyst and biofilm agents; often used together

Co-infections

  • Testing even less accurate
  • Bartonella—more CNS than skeletal S/S
    • Gi upset
    • Gradual onset
    • Can cause rages
    • Responds to Azithro; Sulfa Rifampin; fluroquinolones (cipro; levaquin)
  • Babesia—abrupt onset—night sweats
    • Cycles every few days
    • Fatigue; headache; chills
    • Cough; palpitations
    • Responds to antimalarials: Mepron; Azithro; Clinda Sulfa
  • Ehrlichea/Anaplasma
    • Can have high fever
    • Knife like headache; sore muscles
    • Responds to Doxy; fluroquinolones; rifampin
  • Mycoplasma Pneumo
    • Difficult to treat; sickest patients; major fatigue; neuro s/s

 

Dr. Charles Jones
  • Talked on infection-induced autoimmune encephalitis (Lyme-induced)
  • Few case studies; video of recovered child
  • Bands 31 and 34 increased incidence of autoimmune sequalae
  • Triggers for anti-neuronal antibodies are Strep; MycoP; Lyme and co-infections
  • Treatment—eradicate underlying infection with antibiotic and if necessary IVIG
  • IVIG — Replacement therapy vs. modulating therapy
  • Lower dose of IVIG can sometimes make it worse – t cells stimulate b cells to make more anti neuronal antibodies, causing increase in encephalitic process
  • Success—eradicating the infection and reversing the autoimmune process
  • If an immunization contains a component of an organism in our genome, we make antibodies to this infectious agent and we make antibodies to ourselves.

 

 

Related posts:

NE PANS/PANDAS Conference in Review By Diana Pohlman, Executive Director

Donate to Dr. Agalliu’s Lab: UC Irvine Research (includes information on lab)

Donate to Dr. Cunningham’s Lab: University of Oklahoma Research

Cunningham Paper Links Autoimmunity with Neuropsychiatric Symptoms

PANDAS Network Sun

 

In the newly published paper Dopamine Receptor Autoantibodies Correlate with Symptoms in Sydenham’s Chorea , Drs. Ben-Pazi, Stoner, and Cunningham linked, for the first time, autoimmunity with neuropsychiatric symptoms.

This paper is based on findings in children with SC (Sydenham’s Chorea), but lays the foundation for PANDAS and PANS as well.

Over the past years, clinical research groups have been searching for the targets of autoantibodies in neuropsychiatric illnesses including SC , and related neurologic sequelae of group A streptococcal infections. Since SC is a well established neurologic manifestation of rheumatic fever, it may serve as a prototype for other streptococcal related neuropsychiatric disorders. It is possible that our data may advance the understanding of SC and other childhood neuropsychiatric disorders based on their relationship to anti-D1R and anti-D2R antibodies.

To read the paper in its entirety for free, visit http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3779221/.

 

Related Posts:
Moleculera Labs Opens!
INTERNATIONAL Cunningham Panel of Tests Available through Wieslab
Diagnostic Tests: The Cunningham Panel
“PANDAS and Autoimmunity”-Summary of Dr. Cunningham’s AutismOne Presentation

Dr. Cunningham to Present at “Lectureship in Pediatric Infectious Diseases” 11/6/13

Dr Madeleine Cunningham

Dr Madeleine Cunningham

 

The following lecture will be held by the Harris D. Riley, Jr. Pediatric Society and is open to the public. This teaching seminar will feature Dr. Madeleine Cunningham. It is not an introductory lecture and will include “technical language”.

This would be a great opportunity for Oklahoma pediatricians and providers. Dr. Cunningham will also be presenting in Grand Rounds. On Wed. November 6, 2013.

 

 

The Harris D. Riley, Jr. Pediatric Society invites you to attend the annual Lectureship in Pediatric Infectious Diseases named in honor of Dr. Riley.  Madeleine W. Cunningham, Ph.D. will speak on “Understanding Autoimmune Sequelae in Rheumatic Fever: Carditis and Sydenham Chorea”.  Dr. Cunningham is the George Lynn Cross Research Professor and PHF Presidential Professor Microbiology and Immunology Director, Immunology Training Program, University of Oklahoma Health Sciences Center.  The presentation will begin at 12:15 p.m. on Wednesday, November 6, 2013, in the Samis Education Center, Rainbolt Family Auditorium, 1200 Children’s Avenue, Oklahoma City, Oklahoma.

The Harris D. Riley, Jr. Pediatric Society was established in honor of Harris D. Riley, Jr. M.D., formerly Distinguished Professor and the first full-time Chairman of the Department of Pediatrics, University of Oklahoma School of Medicine. He also served as Medical Director/Chief of Staff of the Children’s Hospital of Oklahoma, and Director of the Infectious Disease program.   The lecture honors Dr. Riley’s interest in and contributions to the field of Pediatrics and Infectious Diseases.

Mark A. Fergeson, M.D. continues to hold the CMRI Harris D. Riley Jr., M.D. Chair – Pediatric Education which was established in 2008.

The membership of the Harris D. Riley, Jr. Pediatric Society comprises house officers and fellows who have had pediatric training at the Children’s Hospital of Oklahoma, current or former faculty members, and other friends of Dr. Riley.

We hope to see you November 6, 2013, for the Harris D. Riley, Jr. Lectureship.

Sincerely,

John H. Stuemky, M.D.

President, Harris D. Riley, Jr. Pediatric Society

 

Related Posts:
“PANDAS and Autoimmunity”-Summary of Dr. Cunningham’s AutismOne Presentation (2011)

INTERNATIONAL Cunningham Panel of Tests Available through Wieslab

Wieslab

UPDATED 9/9/2013

Those not living in the Unites States can now benefit from the newly available Cunningham Panel of Tests through Wieslab!

“Wieslab has formed a partnership with Moleculera Labs in Oklahoma USA, in regards to PANDAS / PANS testing. Wieslab acts as Moleculera’s service partner in countries outside of North America. Consequently, Wieslab has the direct contact with physicians / patients living outside North America. Wieslab collects the samples and ensures that they are sent to Moleculera for processing. Wieslab also manages the invoicing of the samples and delivers the test result directly the physicians.”

The request form can be downloaded here.  It is test #564 in the right column.

The INTERNATIONAL TESTING can be obtained through your physician in any country other than the Unites States. All testing that is needed within the Unites States should still be sent directly Moleculera Labs.

Read and print the detailed instructions of how your physician can order the test here.

Thank you to Wieslab and Moleculera Labs for making this testing available around the globe!

 

Related Links:

 

Moleculera Labs Opens!

Moleculera Labs imageThe long anticipated Moleculera Labs officially open today, April 22, 2013!

This lab will offer a a series of five (5) assays called the “Cunningham Panel”. According to their website, “The collective results of the panel of 5 tests will provide an assessment as to the anti-neuronal and autoimmune state of the patient at the time of testing.  The physician is provided a composite report containing the 5 assay results, each compared to normal controls.  The collective results can aid the physician in determining a proper diagnosis and support the appropriate treatment decision.”

PANDAS and PANS both remain a CLINICAL DIAGNOSIS.

 

Additional Information:

A physician will have to order the Cunningham Panel. Turn around time and cost information is available on the Moleculera Labs website.

 

For more information on Moleculera Labs and the Cunningham Panel, visit their website at MoleculeraLabs.com.

To learn more about Dr. Cunningham’s past research on PANDAS, visit the Diagnostic Test section of our website and read/view Dr. Cunningham’s 2011 AutismOne presentation on the subject.

“Infectious Diseases in Children” Article Now Online

Dr. Swedo, et. al's White Paper on PANS was released in February 2012

 

Infectious Diseases in Children new article, PANDAS to CANS: Evolution of a controversial disorder is available online.

This is a brief history (or evolution) of where some of the confusion about PANDAS came from and the issues we still face. As seen by the choice of title, it lends some bias to the inaccurate, controversial acronymn “CANSthat was developed by the naysayers of PANDAS , but also provides information on the correctly named disorder, PANS (Pediatric Acute-onset Neuropsychiatric Syndromes). Various doctors and researchers are featured in this piece.

We encourage readers to also read the related posts listed below.

 

 

 

Related posts:

 

 

Tel Aviv/Rat Model Study Published!

The long awaited TEL AVIV STUDY has been published!!!  The study is titledBehavioral, Pharmacological, and Immunological Abnormalities after Streptococcal Exposure: A Novel Rat Model of Sydenham Chorea and Related Neuropsychiatric Disordershas recently been released in the newest issue of Neuropsychopharmacology!

Only the abstract of this study is available for free to the public.  This study was to show what occur when strep exposure occurs to this new rat model. Examples of what occurs includes “(impaired food manipulation and beam walking) and compulsive behavior (increased induced-grooming)”.

We thank Drs. Brimberg, Cunningham, Swedo, Joel, Leckman, Benhar, Mascaro-Blanco,  Alvarez,  Lotan,  Winter,  Klein,  Moses, and Somnier for this great work!

 

Behavioral, Pharmacological, and Immunological Abnormalities after Streptococcal Exposure: A Novel Rat Model of Sydenham Chorea and Related Neuropsychiatric Disorders

.

Lior Brimberg, Itai Benhar, Adita Mascaro-Blanco, Kathy Alvarez, Dafna Lotan, Christine Winter, Julia Klein, Allon E Moses, Finn E Somnier, James F Leckman, Susan E Swedo, Madeleine W Cunningham and Daphna Joel

Abstract

Group A streptococcal (GAS) infections and autoimmunity are associated with the onset of a spectrum of neuropsychiatric disorders in children, with the prototypical disorder being Sydenham chorea (SC). Our aim was to develop an animal model that resembled the behavioral, pharmacological, and immunological abnormalities of SC and other streptococcal-related neuropsychiatric disorders. Male Lewis rats exposed to GAS antigen exhibited motor symptoms (impaired food manipulation and beam walking) and compulsive behavior (increased induced-grooming). These symptoms were alleviated by the D2 blocker haloperidol and the selective serotonin reuptake inhibitor paroxetine, respectively, drugs that are used to treat motor symptoms and compulsions in streptococcal-related neuropsychiatric disorders. Streptococcal exposure resulted in antibody deposition in the striatum, thalamus, and frontal cortex, and concomitant alterations in dopamine and glutamate levels in cortex and basal ganglia, consistent with the known pathophysiology of SC and related neuropsychiatric disorders. Autoantibodies (IgG) of GAS rats reacted with tubulin and caused elevated calcium/calmodulin-dependent protein kinase II signaling in SK-N-SH neuronal cells, as previously found with sera from SC and related neuropsychiatric disorders. Our new animal model translates directly to human disease and led us to discover autoantibodies targeted against dopamine D1 and D2 receptors in the rat model as well as in SC and other streptococcal-related neuropsychiatric disorders.Neuropsychopharmacology advance online publication, 25 April 2012; doi:10.1038/npp.2012.56.

PMID: 22534626 [PubMed - as supplied by publisher]

link

 

 


The Pendergrafts & Poarch Families: PANDAS in the News

The news article, Families fight with PANDAS, is the story of the Pendergrafts and Poarch families and their journey with PANDAS.

Beginning with a diagnosis of Asperger’s and then PANDAS, Bridget Pendergraft recalled how,  “it was literally like somebody flipped a switch and all of this came on,  totally out of the blue…We were scared … It was like  everything that we dealt with Asperger’s, amplified times 1,000.”. With the help of antibiotics and homeopathy, it appears things have dramatically improved.

To read the article, please visit Families fight with PANDAS on NewsOK.