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PANDAS is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections.

This diagnosis is used to describe a set of children who have a rapid onset of obsessive-compulsive disorder (OCD) and/or tic disorders such as Tourette syndrome (TS), following group A beta-hemolytic streptococcal (GABHS) infections such as "strep throat" and scarlet fever.[1] The proposed link between infection and these disorders is an autoimmune reaction, where antibodies produced by the infection interfere with neuronal cells.Though PANDAS is used to describe mainly the above disorders but according to recent research it can be associated with stuttering too.Given below is such a case study:We report the case of a 6-year-old male with the sudden onset of stuttering approximately 1 month after a documented streptococcal infection. The patient had no known family history of stuttering. Six months prior to an evaluation for stuttering, the patient presented to his pediatrician for complaints of a sore throat, fever, and general malaise. A rapid streptococcus antigen test was performed at the time and was found to be positive (Genzyme Strep A Test OSOM). Choosing to avoid medications, the parents declined antibiotics. One month later, the patient developed the acute onset of stuttering characterized by sound and syllable repetitions and silent blocking of speech. Three months later, he developed characteristic struggle behaviors of stuttering, facial grimaces and head twitches when a stuttering event occurred while speaking. Five and one-half months after his initial diagnosis of a streptococcal infection, the patient continued to have a positive rapid streptococcus antigen test, an antistreptolysin O (ASO) titer of 400 IU/ml (age-specific normal <200 IU/ml) and an antideoxyribonuclease B (anti-DNase B) titer of 387 U/ml (normal=0 to 70 U/ml). He then began amoxicillin/clavulanic acid, 800 mg/d for 10 days with near resolution of stuttering symptoms within 2 weeks. Streptococcal throat culture after the antibiotic course was negative. The patient remained without stuttering symptoms at the time of this submission (6 months later). This case illustrates that stuttering in some individuals may be viewed as pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS).1 The hypothesis involves that the antibodies created to fight the infection cross-react with the developing basal gangliaa region of the brain implicated in stuttering etiology.2,3 PANDAS are characterized by a waxing/waning course, proposed involvement with the basal ganglia, pediatric onset, and neuropsychiatric symptoms often involving tic-like motions, all of which are associated with stuttering. This case is the first described in the literature of a documented streptococcal infection preceding stuttering weeks prior to onset. This patients recovery may have been spontaneous and unrelated to antibiotic therapy, which, in PANDAS, has been associated with mixed results.4 Although, the concept of PANDAS in other disorders remains open to debate, further research is indicated into this possible etiology of stuttering in a sub-set of individuals No one has suggested that stuttering is a PANDAS disorder, but the three PANDAS disorders (Tourette's, OCD, and tics) are genetically linked to stuttering, so perhaps PANDAS shouldn't be ruled out in the development of stuttering. The PANDAS theory is mainly used for Tourette's syndrome but it can also be used for stuttering because three genes that correlate with stuttering also correlate with Tourette's Syndrome. Tourette's and stuttering have many commonalities, suggesting that the neurology of Tourette's may shed light on the neurology of stuttering. Stuttering happens frequently in Tourette's syndrome. Many of the medications that help control tics also help stuttering. Abnormalities in the basal ganglia and the cortical motor systems may . Touretters control the disorder by substituting more-acceptable tics. Stu The more a Touretter tries not to make a certain movement, or a stutterer tries not to stutter, the less he or she can control the behavior. tterers substitute words they can say. Both Touretters and stutterers enjoy support groups, where they can "let go" and move or stutter without embarrassment.

Environmental cues can "switch off" Tourette's and stuttering temporarily. E.g., a surgeon with Tourette's has tics everywhere but the operating room.[9] Stress can "switch off" Tourette's and stuttering temporarily. Dopamine-blocking medications, such as Haldol, reduce both stuttering and Tourette's. Both disorders run in families. The prevalence of Tourette's and adult stuttering is similar. Both disorders originate in childhood. Both disorders can be disabling, but Touretters and stutterers who achieve success say that their disordbe shared by both disorders. Tourettec tics and stuttering disfluencies are embarrassinger was a gift. But the concept of PANDAS is very complex in nature and hence is pretty controversial at the moment.It is probably for these reasons that PANDAS is currently not listed as a diagnosis by the International Statistical Classification of Diseases and Related Health Problems (ICD) or the Diagnostic and Statistical Manual of Mental Disorders (DSM).

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