Can removing tonsils help with PANDAS?

Yes, removing tonsils (tonsillectomy) can significantly help some children with PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) by reducing symptom severity and recurrence, particularly in cases with frequent strep infections, but results vary, and it's not a guaranteed cure, often used alongside other treatments like antibiotics or IVIG. Studies show improvements, even complete resolution in some, by removing a potential source of persistent strep triggers, though some research indicates mixed effects on symptom progression.

Can a tonsillectomy help PANDAS?

The Georgetown study and physician experience indicates that removal of the tonsils can provide remission of PANS and PANDAS symptoms for some patients. There is no marker to determine which patient a tonsillectomy will result in remission of PANS/PANDAS symptoms.

Can tonsillitis cause PANDAS?

PANDAS is associated with obsessive compulsive disorders (OCD) and tic disorders. The streptococcal infections may trigger an autoimmune reaction that exacerbates these conditions. Recurrent streptococcal tonsillitis is one of the recurrent infections associated with PANDAS.

What benefits does tonsil removal have?

What are the benefits of tonsil surgery? Surgery to completely remove the tonsils (total tonsillectomy) can help to reduce the number of throat infections. The tonsils can no longer become infected – but other areas of tissue in the throat can still become infected.

What is the best treatment for PANDAS?

The best treatment for sudden episodes of PANDAS is to treat the strep infection with antibiotics. Health care providers will order a throat culture to see if strep bacteria are present. If the throat culture is positive, antibiotics are usually prescribed to treat the strep infection and reduce PANDAS symptoms.

To adults considering a tonsillectomy -

What kind of doctor to see for PANDAS?

What kind of doctor treats PANDAS syndrome? Doctors who treat PANDAS syndrome come from a variety of backgrounds. Pediatrics, neurology, hematology/oncology, psychology, psychiatry, integrative medicine, immunology and rheumatology are just a few of the specialties of PANDAS doctors.

What is the downside to getting tonsils removed?

Removing tonsils (tonsillectomy) has disadvantages including significant short-term pain, difficulty eating/swallowing, bleeding risks (sometimes serious), and potential long-term links to increased respiratory/allergy issues as tonsils help immune function, though the extent of long-term impact is debated. Recovery involves a painful two-week period with dietary changes, and risks like infection, bad breath, and voice changes can occur, making the procedure a trade-off between immediate discomfort/risks and benefits for severe cases.
 

What is the 7 5 3 rule for tonsillectomy?

The 7-5-3 rule, also known as the Paradise criteria, is a guideline for deciding if a child needs a tonsillectomy for frequent sore throats, recommending surgery if they have had 7 infections in the past year, or 5 per year for two years, or 3 per year for three years, with each infection documented with fever (>101°F/38.3°C), swollen lymph nodes, tonsil pus (exudate), or a positive strep test. It helps doctors identify when tonsil removal is likely to significantly improve the child's quality of life, though it's a guideline, not a strict rule, and other factors like obstructive sleep apnea are also considered. 

Why are doctors hesitant to remove tonsils?

In fact, “Tonsillectomies are avoided if possible, especially in those cases in which other medical issues are involved, such as heart or lung disease, those who are sensitive to anesthesia, and the elderly.”

Can you have PANDAS without tonsils?

Few cases of this disease in connection with tonsillectomy have so far been reported; hence, this treatment is not standardized. We present here a case study of a boy with PANDAS syndrome who underwent tonsillectomy and improved after surgery.

What are the worst days of tonsillectomy?

The worst days of tonsillectomy recovery are typically Days 3 to 7, when pain peaks due to inflammation and scab formation, often feeling worse than the first couple of days, with potential ear pain and bad breath; pain may briefly worsen again around days 5-9 as scabs start to fall off, but then gradually improves over the next week or two.
 

Can removing tonsils help with behavior?

In the post-adenotonsillectomy patients, breathing and oxyhemoglobin desaturation were improved such that neurobehavioral problems such as inattention and hyperactivity due to hypoxia were clinically improved three months post-operation.

What is the misdiagnosis of pans pandas?

Because the symptoms mimic psychiatric disorders, children with PANS and PANDAS are often misdiagnosed and treated as having a psychiatric condition rather than an auto-immune condition which requires vastly different treatment courses.

Does removing tonsils help ADHD?

Amiri et al. concluded that in children with sleep-disordered breathing associated with ADHD, adenotonsillectomy led to a significant decrease in the severity of ADHD symptoms (21).

Can you fully recover from PANDAS?

If identified and treated early, it is possible to make a full recovery from PANS or PANDAS. However, some people may not respond as well or as quickly to treatment, particularly if treatment starts later.

What's the best age to remove tonsils?

There's no single "best" age for a tonsillectomy, as it depends on the severity of issues like frequent infections or sleep apnea, but surgery is often considered for children aged 3-12 when symptoms significantly disrupt life, with younger kids often having easier recoveries than teens or adults. While waiting until at least age 3 is common to reduce bleeding risks, the primary driver is the problem's impact, not age, though younger children generally heal faster. 

What qualifies you for tonsil removal?

Tonsillectomy criteria usually involve severe, frequent throat infections (like 7+ in a year, 5+ for 2 years, or 3+ for 3 years, with fever/pus/swollen glands) or obstructive sleep issues (snoring, pauses in breathing, mouth breathing) due to large tonsils, according to guidelines from bodies like the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) . Other reasons include recurrent tonsillar abscesses, suspected tonsil cancer, or chronic tonsillitis with bad breath (tonsilloliths).
 

Why don't kids get their tonsils out anymore?

Why the drop? Well, complications are common. In fact, one in five children who have a tonsillectomy has a complication. The most common is breathing difficulty, which can affect one in 10.

What are the signs you need tonsils removed?

You might need your tonsils removed (tonsillectomy) if you have frequent, severe tonsillitis (7+ times a year, 5+ for 2 years, or 3+ for 3 years), chronic sleep issues (snoring, apnea) from enlarged tonsils, or persistent bad breath/tonsil stones that don't resolve, alongside symptoms like difficulty swallowing, chronic throat pain, fever, and swollen neck glands, requiring evaluation by an ENT doctor.
 

What is the alternative to a tonsillectomy?

Alternatives to full tonsillectomy focus on shrinking tonsils (tonsil reduction) with radiofrequency or laser, removing only parts (tonsillotomy) for less pain, or managing symptoms with antibiotics, gargles, and watchful waiting, offering less invasive relief for enlarged tonsils or sleep issues while preserving some immune function, though regrowth is possible. Newer methods like cold plasma treatment are also emerging.
 

Does tonsil removal cause weight gain?

Yes, tonsil removal (tonsillectomy/adenotonsillectomy) is often linked to weight gain in children, especially younger ones, due to easier eating and less energy spent breathing, though studies have mixed results on whether it leads to obesity long-term, with some showing increased calorie intake and others finding no significant long-term risk for becoming overweight or obese. The weight gain is common but not guaranteed, with many experiencing a few pounds or a slight BMI increase, particularly those who were underweight before surgery. 

What can trigger PANDAS?

PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is caused by a strep infection triggering the immune system to mistakenly attack the brain's basal ganglia, leading to sudden OCD, tics, anxiety, and other symptoms, while PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) involves similar abrupt neuropsychiatric symptoms from other infections or triggers, both stemming from this autoimmune misresponse, though research into genetics and specific antibodies continues.
 

Can COVID trigger PANDAS?

This is important, given the hypothesis that additional infections may trigger symptoms of PANS/PANDAS [31]. COVID-19 infection can not only result in an exacerbation of the condition of children already affected by PANS but can also eventually trigger new-onset PANS.

Does CBD help with PANDAS?

Many parents are surprised to learn that THC-free CBD oil can be a gentle, supportive option for kids struggling with PANS symptoms — especially anxiety, OCD-type behaviours, sleep issues, tics, and emotional overwhelm.