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Exploring the Essential Features of “Scott Antoine – PANS/PANDAS: The Role of Infection and Toxin-Mediated Neuroinflammation in Mental Health Disorders”
Speaker: Scott Antoine, DO, FACEP, ABOIM
Duration: 1 Hour 03 Minutes
Format: Audio and Video
Copyright: Nov 03, 2023
Media Type: Digital Seminar
Description
In the early 1990s, a group of researchers at the National Institute of Mental Health began collecting data on children who had developed neuropsychiatric disorders (OCD and tics) following infections. They found evidence that antineuronal antibodies had developed in some of these children which attacked the basal ganglia region of the brain. MRI and PET scans in these children also demonstrated inflammatory changes in the basal ganglia. In 1997, the researchers published the first article to describe this syndrome that they named PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep infections).
In PANDAS, an autoimmune attack on the brain occurs following a Strep infection. PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) is a broader term that also includes cases following exposure to other infections, toxins, and even stress. Clinicians treating children with PANS and PANDAS have found that antibiotics targeted at the offending organisms, steroids, and IVIG results in marked improvement and occasionally complete remission of the neuropsychiatric symptoms.
Disturbing symptoms consistent with many DSM-5 psychiatric disorders manifest in patients with PANS and PANDAS—yet we know that there is a biologic basis for the changes in these children. As a result, these disorders require us, as physicians and society, to view mental illness in an entirely new way. Resistance to this change in paradigm has made PANS and PANDAS difficult for clinicians to diagnose, unbearable for parents to endure, and controversial for scholars to accept.
PANS and PANDAS are complex disorders that demand a rich, multifaceted response with novel treatment approaches.
This lecture, by one of the world’s top experts in PANS and PANDAS, will explain the actual link between immune dysregulation in these children and the development of these syndromes. In this presentation, participants will find conclusive evidence from the peer-reviewed medical literature for the existence and pathophysiology of PANS and PANDAS, alongside testing and treatment interventions the author has successfully used in his own practice with hundreds of children.
Speaker
Scott Antoine, DO, FACEP, ABOIM, completed his undergraduate training at the University of Scranton, his doctorate at the Philadelphia College of Osteopathic Medicine and his emergency medicine residency and fellowship at Albert Einstein Medical Center in Philadelphia. He served seven years of active duty with the United States Army as an emergency physician, followed by a practice as an emergency physician at St. Francis Hospital in Indianapolis. In addition to his board certification in emergency medicine, he achieved board certification in integrative medicine through the newly formed American Board of Integrative Medicine in 2016. He also holds certifications in functional medicine through the Institute for Functional Medicine and A4M. In 2013, his daughter developed Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). He and his wife Ellen, also a functional and integrative medicine physician, were able to shut off the immune response, treat the infections and toxins responsible for her PANS presentation and bring her to full recovery. After his daughter recovered from PANS, he knew his specialty had found him. Since then, he has refined his process and has helped hundreds of children recover from PANS and PANDAS. In 2019, he successfully lobbied the Indiana legislature and helped pass a law which prohibits insurance companies from denying coverage from medical care (including IVIG) for children with PANS and PANDAS.
Speaker Disclosures:
Financial: Dr. Scott Antoine is the owner of The Center for Fully Functional Health®. He receives a speaking honorarium and recording royalties from Psychotherapy Networker and PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Scott Antoine is a member of the American Medical Association, the Institute of Functional Medicine. the American Academy of Anti-Aging Medicine, the American Academy of Ozonotherapy, the American College of Emergency Physicians, and the American Board of Emergency Medicine.
Objectives
- Define PANS and PANDAS.
- Describe common presentations of these disorders and current diagnostic criteria.
- Analyze the role of molecular mimicry in the genesis of autoimmune diseases.
- Explain the concept of immune dysregulation in PANS and PANDAS and causative factors.
- Identify the role of laboratory and radiology testing in children with PANS and PANDAS.
- Define common infections and stressors which may precipitate flares.
- Define the four aspects which must be addressed by both parents and physicians to successfully treat PANS and PANDAS.
Outline
The History and Science Behind PANS and PANDAS
- Definitions of PANS and PANDAS
- Molecular Mimicry as a Causative Factor in Autoimmunity
- Anti-neuronal Antibodies in PANS and PANDAS
- Radiographic and Experimental Evidence of Basal Ganglia Pathology in PANS/PANDAS Patients
- Origins of the Controversy Surrounding PANS and PANDAS and Evidence-based Medicine
Diagnosing PANS and PANDAS
- Classic Criteria
- A Detailed Description of Symptoms and Physical Exam Findings
- The Role of Laboratory and Radiology Testing in PANS and PANDAS
- Specific Testing Performed in Patients with PANS and PANDAS
- The Importance of Excluding Other Causes of Acute Neuropsychiatric Changes
The Four Vitals Areas That Must Be Addressed to Promote Long-term Healing in PANS and PANDAS
Finding and Eliminating Infections and Biofilms
Finding and Removing Toxins and Toxicants
Re-regulating the Immune System
Breaking Neurologic Loops (OCD/Anxiety)
Valuable Treatment Adjuncts for Patients with PANS and PANDAS
- Exposure Response Prevention/CBT
- Neurolinguistic Programming (NLP)
- Hypnosis
- Family Counseling and Guidance
- Resources to help at School, with Friends, and with Family
Future Treatment Directions
- State Campaigns to Prevent Insurance Denials of IVIG
- Physician and Other Healthcare Provider Education
- Immune Modulators and Targeted Therapies
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