Monarch Elena S, Foss Sean
Lyme and PANS Treatment Center, Hingham, MA, United States.
Front Child Adolesc Psychiatry. 2025 May 22;4:1377547. doi: 10.3389/frcha.2025.1377547. eCollection 2025.
Sudden-onset, unexplained, and treatment-resistant neuropsychiatric symptoms have been reported in numerous pediatric patients. Prior to the identification of neuroimmune conditions including PANS and PANDAS, children with these conditions were diagnosed with psychiatric and neurological conditions and offered conventional psychiatric and therapeutic care. As connections between the immune and nervous systems become clearer, alternate curative treatments have emerged. This case series presents three pediatric patients' treatment experiences with sudden-onset severe neuropsychiatric symptoms such as disabling anxiety, tics, eating restriction, or hallucinations, and their full recoveries following treatment of their underlying infections, inflammatory responses, and gastrointestinal dysbiosis. Treatments included antimicrobials, nutraceuticals, probiotics, and dietary changes. Converging lines of research highlight the importance of considering neuroinflammatory conditions in the differential diagnosis of children with treatment-resistant neuropsychiatric symptoms.
众多儿科患者中报告了突发、不明原因且难治的神经精神症状。在识别出包括儿科自身免疫性神经精神障碍相关链球菌感染(PANS)和儿科自身免疫性神经精神障碍(PANDAS)在内的神经免疫疾病之前,患有这些疾病的儿童被诊断为患有精神和神经疾病,并接受传统的精神和治疗护理。随着免疫和神经系统之间的联系变得更加清晰,出现了替代治疗方法。本病例系列介绍了三名儿科患者在出现突发严重神经精神症状(如致残性焦虑、抽搐、饮食限制或幻觉)后的治疗经历,以及在治疗其潜在感染、炎症反应和胃肠道生态失调后完全康复的情况。治疗方法包括使用抗菌药物、营养保健品、益生菌和饮食调整。越来越多的研究表明,在对难治性神经精神症状儿童进行鉴别诊断时,考虑神经炎症性疾病非常重要。