An Introduction to PANDAS, a Rare Disorder That Can Cause Violent Behavior in Children

According to a story from ABC News, Alexia Baier was four years old when she came down with strep throat, an infection caused by group A streptococcus bacteria. It is a relatively common infection for children to experience, and a ten day round of antibiotic treatment was able to resolve the infection. However, something changed about Alexia after her treatment.


Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a poorly known and controversial diagnosis. A significant proportion of the medical community still doubts that the disorder even exists. The possible origin of PANDAS lies in changes to the immune system after an infection. These changes cause to immune system to affect the function of the brain. This results in symptoms such as personality changes, OCD like behaviors, tics, anxiety, deterioration of handwriting, and urinary incontinence. In diagnosed patients, the onset of symptoms and changes is very sudden. Treatment for PANDAS is mostly symptomatic, so therapies for tic disorders and OCD apply. Overall, the diagnostic criteria for PANDAS are poorly defined, and there is some concern that it may be overdiagnosed. To learn more about PANDAS, click here.

Alexia’s Story

Alexia was a well-behaved child and also excelled in the classroom, such as counting and painting. She also got along well with other children. But the sudden onset of PANDAS changed everything. In just two days after finishing her antibiotic treatment for strep, Alexia began to display remarkably aggressive behavior both at home and in school. She often would defy the instructions of teachers and her mother Vanessa.

This often meant bouts of kicking and hitting at adults. The more disciplinary action was taken, the angrier Alexia seemed to get. There was even an episode in which she attacked her mom. Eventually, the threat of both self-harm and injury to others simply became too great, and Alexia was admitted for residential observation and treatment.

It took a while for doctors to diagnose PANDAS. She was first diagnosed with bipolar disorder and was sent home after nine days. It took a visit to a neuropsychologist before a correct diagnosis was made.

Getting Treatment

There is still a significant portion of the medical community that does not think that PANDAS is real, meaning that it can be a challenge for families to find a doctor that will treat it. Thankfully, Alexia is doing much better now at age 8. Her PANDAS appears to be under control, and when symptoms occur, antibiotics are able to bring her back to normal.

Raising Awareness

The Baier family’s experience with this unusual disorder led to their involvement in advocacy, and they played a role in getting a new law passed in Illinois that required insurers to cover PANDAS treatment. Hopefully, awareness about this unusual disease will continue to grow.

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