Durham, N.C. — The parents of a 10-year-old Raleigh boy began noticing strange behavior in their son about a year ago but had no idea that it could be the result of strep throat.
Chris Martin complained of stomachaches and restlessness, his parents said.
"He would, all of the sudden, just blank out and become unresponsive," Amy Martin said. "He was having, just, tics and OCD behavior like crazy."
Chris had increasing anxiety, and his school work began to suffer.
"He'd ask me to take him to the hypnotist so that he could forget his bad thoughts," Tim Martin added.
Chris never had a fever or sore throat, but because of the neurological complications, doctors eventually gave him a strep test, which came back positive.
Left undiagnosed and untreated, strep throat can result in scarlet fever, rheumatic heart disease or in rare cases, pediatric autoimmune neuropsychiatric disorder associated with streptococcus, or PANDAS.
"The PANDAS syndrome is characterized by the rapid and explosive onset of two major psychiatric symptoms – obsessive compulsive disorders and tics," said Dr. Richard D'Alli, a pediatric psychiatrist at Duke University Hospital.
PANDAS occurs is less than 1 percent of children with strep throat. If a child suddenly begins showing obsessive compulsive behaviors and tics, such as repeated blinking or scratching, parents should ask their doctor for a strep test.
Antibiotics and cognitive behavior psychotherapy are required to treat PANDAS. In some cases, doctors also prescribe anti-depressants.
Chris takes the medications while he is in school.
"It helps me to focus more in class," he said. "(And) just stops the stomachaches."
In the year since his diagnosis, Chris is progressing.
"I'm feeling less worried, sometimes I get a little timid," he said.
"My hope is that he will be normal and be just fine," Amy Martin said. "That's my hope."




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February 25, 2013 4:02 p.m.
February 22, 2013 7:32 p.m.
February 22, 2013 10:41 a.m.
The diagnostic criteria is not limited to OCD or tics. In fact, many children do not have tics with PANDAS (some do).
There is now mounting evidence that other infections trigger this autoimmune disease; Mycoplasma, Lyme disease, viruses (coxsackie, HHV6, EBV) to name a few.
I am glad this child has found interventions that work for him, but it should be noted that many PANDAS kids have had severe adverse reactions to psych medications.
Based on shared experience from other parents it is my understanding that Duke was turning away PANDAS patients & have a lot to learn about PANDAS.
February 21, 2013 5:47 p.m.
My son was diagnosed 8 years ago (his was 6 years ago) when we were referred to a neuorologist for all sorts of scary symptoms. After testing for brain tumors, she did a strep test and his titer (a blood test for the presence of antibodies) was 10 times the normal level, which indicates exposure. The symptoms responded very well to the antibiotics she gave him.
He still has occasional bouts, but at least now we know what it is and how to deal with it. The OCD symptoms are only one of the many symptoms one can experience with this.
February 21, 2013 11:34 a.m.