Can Tonsillectomy Help Kids with PANDAS? A Look at the Evidence

Dr. Kumar’s Take:

This study adds to the small but growing body of research on tonsillectomy as a possible treatment for PANDAS, especially when antibiotics fail. While it’s a small retrospective case series, the findings are promising: 9 out of 10 kids experienced symptom relief after tonsillectomy, and 4 had complete resolution. For families struggling with recurrent strep infections and persistent OCD or tics, this could offer an additional option to consider.

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Do Surgeries or Medications Help Kids with PANDAS OCD? Here's What the Research Shows

Dr. Kumar’s Take:

This systematic review looked at whether medical treatments like antibiotics, IVIG, and steroids—or surgical options like tonsil and adenoid removal—help improve OCD symptoms in kids with PANDAS or PANS.

While both surgery and medication showed benefits, one treament didn’t stand out over the others. This highlights the urgent need for larger, high-quality studies with clear protocols. Until then, treatments should be individualized and often involve a combination of approaches.

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PANDAS Triggered by Strep and Rapid Recovery with Antibiotics

Dr. Kumar’s Take on PANDAS

This study shows that PANDAS can appear suddenly in children after a mild group A strep infection and that treating the infection quickly often leads to rapid symptom relief. The real opportunity is early recognition: a child with abrupt OCD, separation anxiety, tics, or behavioral shifts should trigger evaluation for PANDAS with throat testing and prompt antibiotic therapy.

Key Takeaways

✔ PANDAS episodes were prospectively linked to recent group A streptococcal infections in a primary care setting.
✔ Antibiotics at the first PANDAS flare led to symptom improvement usually within two weeks.
✔ Recurrences of PANDAS aligned with new strep infections and again responded to antibiotics.
✔ More prior strep exposures before onset predicted a relapsing PANDAS course.
✔ Strep triggers were often clinically mild, so PANDAS can be missed without active suspicion.

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