PANDAS: Integrated Naturopathic Psychiatry and Autoimmune

January 29, 2025

PANDAS: Integrated Naturopathic Psychiatry and Autoimmune

By Dr. Nicole Sundene

PANDAS and PANS are very frustrating and often misdiagnosed mental health disorders caused by persistent strep infection in the throat or bladder that generally happen in children and young adults. 

PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. Whereas PANS is not autoimmune and stands for Pediatric Acute-onset Neuropsychiatric Syndrome. Both are specific forms of basal ganglia encephalitis that often appear suddenly after infections, like strep throat, strep bladder infections, and require MRI with contrast of the basal ganglia to detect as well as blood testing and blood marker antibodies against strep as well as other autoimmune disease testing.  

I put a picture of my favorite animal up, the Panda, that is cute because there is nothing cute about this condition, especially the fact that many doctors do not understand it, fail to diagnose it, totally botch the treatment of it, and instantly determine the child, teen, or young adult has gone insane and put them on antipsychotic drugs wrongfully that actually make them more psychotic  and zombie like just like in my story about “Post Viral Psychoses.” 

Symptoms of PANDAS can range from mild to severe and include: 

  • OCD: Obsessive Compulsive Disorder
  • New fears and phobias
  • Insomnia
  • Facial Tics and Muscle Spasms
  • Uncoordinated Movements
  • Sensory issues ie: tags rubbing wrong, textures feeling weird in mouth so won’t eat food
  • New food restrictions or Food Sensitivities
  • Inability to participate in school or sports
  • Sudden lack of coordination
  • ADHD symptoms new onset or worsening in concentration
  • Staring into space
  • Unable to talk or Mutism
  • Catatonic or nonresponsive
  • Joint Pain
  • Fever
  • Abdominal Pain
  • Chronic Fatigue
  • Separation Anxiety

What causes the symptoms of PANDAS? 

The immune system creates a storm of inflammation from constantly fighting and losing a strep battle which then results in attacking the Basal Ganglia of the brain. 

While the Basal Ganglia is under immune attack the following occurs: 

  • Lack of Motor Control
  • Inability to start, stop, and initiate actions
  • Executive functions such as ability to make decisions, rationalize and reason are gravely impaired.  
  • Emotions lacking or heightened
  • Lack of Motivation as the reward system is damaged in the brain
  • Abnormal eye movements
  • Inability to learn
  • Slowed movements
  • Difficulty with balance and coordination
  • Tremors and Facial Tics
  • Muscle Spasms and rigidity
  • Trouble walking
  • Parkinson’s like movements
  • Vision Problems: Blurry vision, visual impairment, sensitivity to light
  • Speech Difficulties: Either lack of speech or slurred and garbled speech
  • Headaches and Migraines
  • Fever
  • Memory issues, brain fog, Inability to remember anything or recall
  • Sleep issues: Constantly sleeping or insomnia
  • Restrictive Eating, New Eating Disorder, Texture Issues with Food
  • Bedwetting, Frequent Urination, Bladder Urgency
  • Joint Pain

If you or a loved one suspect you have PANDAS or PANS this is an ER trip that requires immediate assessment and MRI of the brain. Please do not schedule to meet with me as your Naturopathic Doctor about a medical emergency!

However, I will be happy to help once the ER has discharged the PANDAS patient and determined they are stable for out patient care, that is where I step in, but first all other severe conditions must be ruled out by the ER. 

At that point in my experience many doctors are not skilled or trained in treating this complex condition and Naturopathic Medicine seems to excel as it helps to reduce the inflammation to the brain and aid with recovery. Therefore I have posted this blog for frustrated parents that feel hopeless not understanding why their child is no longer functioning normally. Please use this for informational purposes and schedule an appointment with a skilled, trained and experienced PANDAS Specialist such as myself!

Simply visit my SCHEDULE page to get started with the PANDAS recovery process. 

Dr. Nicole Sundene

(480) 837-0900

Dr. Sundene has twenty six years of experience in health care and is the author of "The Hormonal Acne Diet." She specializes in Autoimmune Disease, Women’s Health, Holistic Dermatology and Hormones. She is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert  in Women's Health and Bioidentical Hormones. Dr. Sundene specializes in Holistic Women's Health conditions for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 26 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease.

She has been an Herbalist for over 30 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!

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Dr. Nicole Sundene 
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