Sunday, May 14, 2017

Post Infectious Neurological Syndrome (PINS)

Post Infectious Neurological Syndrome (PINS)


Every parent and grandparent needs to look out for changes that happen after a child gets an infection. This used to be called names like PANDAS. Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infection. Or it would be called PANS. Pediatric Acute-onset (acute onset) Neuropsychiatric Syndrome.


These names miss the main problem. These names do not describe the cause or the symptoms accurately. In PINS a parent notices a change in their child after an inflammatory condition, that is all.


The condition can be as simple as a common cold. Or it can be some other virus, like coxsackie virus, or even the flu virus. Or it can be a bacteria like streptococcus or strep as it is commonly called. Strep is a common symptomatic bacterial infection in children. It may also my be an undiagnosed bacteria or even one that has not been identified.


Many patients will complain that their observations about the changes in their child's behaviors are dismissed by their doctors. I often see that children with tics or other physical twitches are told that they will grow out of the symptoms when they get older. Even though this may be true it doesn't prevent the current experience of suffering that the child or parents may be going through.


Sometimes parents hear that they have to live with the symptoms because the person they are going to, does not have any good tools to deal with the situation. Sometimes antibiotics can help temporarily if the inflammation is being caused by a bacteria or by something excreted by a bacteria. But many cases of PINS are caused by viruses or some other cause.


It should not be controversial that infections can create a mental or behavioral change. In fact it is pretty clear that every infection creates a mental change. Depending on the patient these effects may last or may go away rapidly. But we know that there are many infections that create permanent changes.


One infection that many people have is toxoplasmosis. This is an infection we get from cats. Half of all people have this infection. Once you have this infection you have it your whole life. When they study men and women that have this infection and compare them to people that don't have infection, they find some personality differences.


Men with toxoplasmosis infection are more aggressive. Women with the infection are more compassionate. Both men and women are more sensitive to the feelings of others. Some people would argue that these are positive changes made to our nervous system made by a bacteria. The research on the changes made by toxoplasmosis to our nervous system are fairly well supported by the research, and not many medical professionals would argue about that.


So we know that the presence of one bacteria and permanently change our nervous system, specifically our brain and personality. It is possible that toxoplasmosis is the only microbe that can affect our nervous system. My guess would be that every organism has the ability to affect our nervous system. In fact if we look at the nervous system as part of our immune system then we know for sure that micro-organisms interact with our nervous system.


So if anyone tells you that a child can't have a symptom after any infection they are not basing that advice on a thorough understanding of the immune system or the nervous system. Also imagine that very often the causative organism, bacteria, virus or micoplasm can't even be identified. If the organism can not be identified how can we know what symptoms could be being created by the bug? Even if streptococcus is identified in the case we have to remember that many bacteria travel together and even if strep is identified and treated that does not often mean that the case is solved and that the child will be symptom free.


Many strep cases treated with antibiotics end up as pandas or pans cases. Or this is what I call PINS. These antibiotics kill the strep bacteria, and yet many kids end up having symptoms after their infections are supposedly successfully treated. So what is the right approach to treat the case?


In thinking about the case we have to look at a few different parts. The first part is the bug. We have to look at the signs that were present in the infection and the signs that are still present. Can they tell us what bug we are treating? Understanding that can be part of the solution. Understanding which bacteria or virus we are working with can help us pick the right homeopathic or herbs or conventional medicine that can help.


Another very important part of the case that needs to be looked at is the child's immune system. One of the best ways to understand the immune system is to look at the parents and other siblings. If there are a lot of inflammatory symptoms in the parents or the siblings then we have a good idea that the problem is more the child then then the bug. It is possible for the bugs to be a normal, part of our environment, and the problem can be an immune system that is over reacting to the bug.


In those cases it is less important to focus on killing the bugs then in calming down the over reaction of the immune system. Depending of the case one way to do this is to identify and eliminate food allergens until the body has a chance to calm down and get back to a normal level of immune system reaction that does not cause neurological symptoms or mood changes.


In any case it is important to pay attention to the changes that occur in your child after an infection. Even if your concerns are dismissed, it is important to trust what you are observing. Because one obvious symptom may hide other symptoms that will not show up until later.