The Immune-Brain Interface: Exploring PANS and PANDAS in Pediatric Neuropsychiatry
DOI:
https://doi.org/10.53819/81018102t4279Abstract
PANDAS/PANS is a burdening disorder that affects children, adolescents and caregivers. Despite numerous investigations to establish evidence-based interventions and clinical practices, more controversies and disagreements arise. This quantitative literature review established fundamental evidence regarding viral infections, bacterial infections, comorbidity, antibiotic therapy and immunotherapy. We conducted a qualitative and quantitative literature search on, Google Scholar and PubMed/Medline. The Boolean operators were used to combine search terms. An additional manual search was performed on the reference lists of the potential literature. The literature search was limited to English publications between 2014 to 2024. Results: Literature shows diverse aspects of PANDAS and PANS among children with OCD, adolescents, and other populations. The disease has been associated with bacterial and viral infections. We found a wealth of evidence on the controversial antibiotic therapy, comorbidities, immunotherapy and reports on infections. Proponents of bacterial and viral infections, alongside antibiotic therapy, emphasized the role of the infectious agents and the therapeutic effects of the antibacterial agents. Additionally, the importance of immunotherapy, NSAIDs and corticosteroids emerged, marking fundamental developments in the management of the disorder. Streptococcal and viral infections are risk factors of PANDAS/PANS, while immunotherapy, corticosteroids, NSAIDs, and antibiotic therapy produce positive clinical outcomes. However, this literature review established controversies on comorbidity, and antibiotic therapy as doctors disagree. However, we found that the authors agree that anxiety is a common comorbid disorder.
Keywords: Immune-Brain Interface, PANS, PANDAS, Pediatric Neuropsychiatry, Neuroimmune Disorders
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