PANS Patient Care
Our multidisciplinary team is dedicated to incorporating our research findings into clincal care. We strive to provide high quality, patient-centered, and compassionate care. We tailor medical and psychiatric care based on the needs of the patient and their families.
Patients in our clinic are provided with leading-edge treatment, diagnostic tests, and ancillary care.
CLINIC REFERRAL INFORMATION
We are now accepting patients located within the following surrounding counties of Stanford: Marin, San Mateo, Santa Clara San Francisco, Contra Costa, Alameda, Santa Cruz, Monterey, Napa, Sonoma, Solano, San Benito, and Sacramento
Patients who are NEW-ONSET, HYPER-ACUTE onset, and UNTREATED will have priority and their entry into clinic will be expedited. Please continue (click) to learn about our intake process.
PANS Symptom Criteria
- Many children with PANS are extremely ill. Diagnostic tests help us uncover inflammatory conditions which may be contributing to neuropsychiatric symptoms.
As part of our comprehensive evaluation, we conduct an extensive past medical record review to better understand each patients’ risk for immune dysregulation and to understand the history of neuropsychiatric symptoms. We are committed to be key team players in managing their complex care.
Our team provides holistic medical and psychiatric management in caring for our patients:
- Preventative Medicine
- Rheumatology/Autoimmune expertise
- Psychiatry (O.C.D. & mood expertise)
- Allergy (food intolerance expertise)
- Immunology (immunodeficiency expertise)
- Behavioral Therapy
- Hospital Education Advocacy
Treatments for Controlling Immune Response
Based on the patient's clinical work-up and preliminary treatment guidelines developed by the PANS research consortium, we consider the following interventions for each patient:
1) Judicious use of antibiotics in select cases.
- Non-steroidal anti-inflammatories (NSAIDs)
- Short oral prednisone bursts for discreet flares in the disease
- High dose IVIG for severe flares
- High dose pulse solumedrol for severe flares not responsive to IVIG
- Plasmapheresis for life-threatening or refractory disease
3) Preventative strategies for patients with identified immunodeficiency including low dose IVIG and prophylactic antibiotics.
4) For patients who are found to have a clear autoimmune process based on elevated inflammatory markers or auto-antibody markers linked to known rheumatologic disease (vasculitis, lupus cerebritis, Sydenham's chorea, etc.). We use tailored immunomodulatory therapy for their condition.
5) For patients found to have concurrent arthritis, we provide tailored antirheumatic therapy.
6) Since most insults to the brain, including inflammatory insults that likely damage neuronal pathways, a cornerstone of our clinical program is rehabilitation through cognitive behavior therapy, occupational therapy, and physical therapy.
**These treatment services are tailored to each individual and may not be appropriate for everyone.
For additional information, we also recommend visiting the following websites, which may be helpful to children with PANS and their primary care provider. These websites have the most up-to-date information regarding PANS:
- National Institue of Mental Health (NIMH) PANS/PANDAS
- PANS/PANDAS Physicians Network (PPN)
- Revised Treatment Recommendations Released for Pediatric Acute-onset Neuropsychiatric Syndrome (PANS/PANDAS) - published July 2017 in Journal of Child & Adolescent Psychopharmacology (JCAP press release)