Teresa Gallo, Parent, West Coast PANDAS/PANS Symposium April 2014

Published on May 15, 2014

Teresa Gallo tells her story of hope about her daughter Tessa.

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Oregon suspect in alleged high school bomb plot said to have Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS)

By Michael MuskalMay 28, 2013, 10:36 a.m.

 A 17-year-old suspect accused of planning an attack on an Oregon high school suffers from a rare form of obsessive-compulsive disorder, his mother said, as officials prepared Tuesday to arraign the student.

Grant Alan Acord, 17, is scheduled to be arraigned in Benton County Circuit Court on one count of aggravated attempted murder, six counts each of manufacturing a destructive device, and related charges, and is to be tried as an adult. He was arrested Thursday at his mother’s home in Albany, Ore., where police have said they seized numerous explosives from a hidden floor compartment in his bedroom.

Benton County Dist. Atty, John Haroldson said in an interview with the Associated Press on Saturday that the alleged plot was “forged and inspired” by the 1999 massacre at Columbine High School in Colorado. He said investigators found six bombs in a secret compartment under the floorboards of Acord’s bedroom, along with written plans, checklists and a diagram of the school.

Acord’s classmates have told reporters that the 17-year-old discussed bomb-making in the weeks before his arrest, but did not speak of any intent to inflict damage.

Thomas Stone, who attends West Albany High School, told KATU-TV that Grant Acord discussed bomb-making materials with him in class a couple of weeks ago.

“You know, I didn’t think much of it ’cause he’s kind of a strange kid,” Stone said. “So I wasn’t surprised he had some strange hobbies, you know?”

Early Tuesday, Acord’s mother, Marianne Fox, released a statement through her attorney to CNN saying her son suffers from a rare form of obsessive-compulsive disorder, known as PANDAS, an acronym for pediatric autoimmune neuropsychiatric disorder associated with streptococcus.

“My heart goes out to everyone affected by Grant’s struggle with PANDAS, a rare form of OCD,” Fox said. Click here to read more.

World J Biol Psychiatry. 2007;8(3):201-7.

Chain reaction or time bomb: a neuropsychiatric-developmental/neurodevelopmental formulation of tourettisms, pervasive developmental disorder, and schizophreniform symptomatology associated withPANDAS.

Source

Department of Neuroscience, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND 58202, USA.

Abstract

We present the case of a boy who over time sequentially exhibited symptoms consistent with a pervasive developmental disorder, schizophreniform symptomatology, multiple motor and vocal tics, and myoclonus. During this period he experienced multiple episodes of group A beta-haemolytic streptococcal (strep) infection confirmed by culture and serological studies. We speculate that paediatric autoimmune neuropsychiatric disorder associated with strep (PANDAS) may have served as an element in a complex chain of causation influencing the expression of his symptoms. Our main emphasis is to utilize our case study as an example of the application in case formulation of the neuropsychiatric developmental model and of the neurodevelopmental model on symptom ontogenesis and clinical outcome.

World J Biol Psychiatry. 2009;10(4 Pt 3):1037-8. doi: 10.1080/15622970802049767.

Neuropsychiatric-developmental model for the expression of tics, pervasive developmental disorder, and schizophreniform symptomatology associated with PANDAS.

Neuropsychiatric Disorders Associated With Streptococcal Infection: A Case-Control Study Among Privately Insured Children

Abstract

Objective

To assess whether antecedent streptococcal infection(s) increase the risk of subsequent diagnosis of obsessive-compulsive disorder (OCD), Tourette syndrome (TS), other tic disorders, attention-deficit/hyperactivity disorder (ADHD), or major depressive disorder (MDD) in a national sample of privately insured children.

Method

Using health insurance claims data, we compared the prior year’s occurrence of streptococcal infection in children ages 4 to 13 years with OCD, TS, or tic disorder newly diagnosed between January 1998 and December 2004 to that of a cohort of matched controls. Conditional logistic regression models were used to determine the association of prior streptococcal sore throat or scarlet fever with a diagnosis of OCD, TS, or tic disorder. We repeated the analyses for two other infectious diseases (otitis media and sinusitis) and one noninfectious condition (migraine). We also investigated the potential specificity of this association by performing similar analyses focused on newly diagnosed ADHD and newly diagnosed MDD.

Results

Subjects with newly diagnosed OCD, TS, or tic disorder were more likely than controls to have had a diagnosis of streptococcal infection in the previous year (odds ratio 1.54,95% confidence interval 1.29–2.15). Prior streptococcal infection was also associated with incident diagnoses of ADHD (odds ratio 1.20, 95% confidence interval 1.06–1.35) and MDD (odds ratio 1.63, 95% confidence interval 1.12–2.30).

Conclusions

These findings provide epidemiologic evidence that some pediatric-onset neuropsychiatric disorders, including OCD, tic disorders, ADHD, and MDD, may be temporally related to prior streptococcal infections. Whether this is the result of a nonspecific stress response or secondary to an activation of the immune system remains to be determined.

Tourette’s syndrome and ‘PANDAS’ Will the relation bear out?

  1. Roger Kurlan, MD

ABSTRACT

Despite strong evidence of the importance of hereditary factors in the etiology of Tourette’s syndrome (TS), research findings have consistently pointed to a role of environmental influences. A recent line of research has suggested that tic disorders and associated behavioral disturbances, such as obsessive-compulsive disorder, might develop following streptococcal infection by the process of molecular mimicry, whereby antibodies directed against bacterial antigens cross-react with brain targets. Such investigations have given rise to the notion that there is a spectrum of childhood neurobehavioral disorders (termed pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection [PANDAS]) that arise by postinfectious autoimmune mechanisms. This article reviews research results supporting the concept of PANDAS and discusses their limitations. Well-designed and adequately controlled studies are needed to determine whether there is a true etiologic relation between streptococcal infection and the onset or exacerbation of childhood neuropsychiatric disorders and whether the use of immune-modifying therapies for these conditions is rational.

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