How do I know if this is PANS?

[Rachel W]

Hi Natasha,

Since starting to research OCD I’ve come across so much information on PANS/PANDAS but skipped over it because I thought it didn’t apply. But I just learned that PANS can happen post-Covid, and I think that’s exactly what happened. My husband and I were very sick with Covid starting May 9th or 10th last year. We weren’t sure if our then 10-year old got it. We never tested him, but a few times we heard him cough the same kind of cough that we had. But that was it. Then on May 20 his extreme worry/OCD began. Overnight, the kid I knew was gone. The kid who loved nothing more than being in the woods could not even go outside for fear of poisonous plants and mushrooms. He had a complete meltdown when riding in the car with the window down because he was convinced that a speck of water hemlock had blown in the window and into his mouth. He also began washing his hands constantly and putting shoes on without touching them. Over time the theme changed to other forms of health anxiety, and gradually lessened in intensity. It never went away completely but came back with a vengeance about 3 months ago, with the new theme being moral OCD/confessions.

Until now I was assuming that his issues were triggered by the stress of seeing both his parents very sick. I have health anxiety myself and I’m afraid he overheard me expressing my worst fears to my husband (he was listening at the door). But now I think PANS is a possibility too. Do you think it’s likely that this is PANS? Is there a way to know for sure? And if it is then how do I go about treating it? I know we need to do ERP, but I assume antibiotics would not apply since Covid is viral. I can’t find much information on what to do for PANS triggered by Covid.

Thanks so much!

[Natasha]

Hi Rachel,
Early research is starting to show a relationship between inflammation in general and OCD. To me it is not surprising that Covid (which causes inflammation) can trigger symptoms of OCD. Often treatment involves treating inflammation. It is hard at times to find the “smoking gun” with PANS. You can try a PANDAS/PANS doctor: https://pandasnetwork.org/. Often part of treatment is anti inflammatory medications (like NSAIDs- motrin).

[Rachel W]

Thank you Natasha. I looked at the website and called the one number in my state, which is the Dartmouth PANS clinic. I talked to an amazingly helpful nurse practitioner who feels pretty certain that my son has PANS, based on what I told her. She says they have seen many cases of post-Covid PANS. I can’t believe I didn’t figure this out sooner but I’m glad I’m finally putting it together. Once I get a referral in, it will take about a month to get an appointment. Is there anything I can do in the meantime? Should I start him on ibuprofen and if so what dose? Thanks for all your help.

[Natasha]

Oh good! I’m glad you are on the right path. I can’t give medical advice. I would ask the nurse if they suggest ibuprofen and at what dose to start.

[Author]

Posts