Homeopathy &

PANDAS/PANS

Elisa H. Song, MD CEDH USA International Conference

June 25, 2016

Whole Family Wellness, Inc.

holistic medicine for your body, mind & spirit

5th International CEDH Conference - June 24-26, 2016

A Very Brief Intro to

PANDAS/PANS

5th International CEDH Conference - June 24-26, 2016

WHAT IS PANS/PITAND/PANDAS

Pediatric Acute-Onset Neuropsychiatric Syndromes

(PANS)

Infectious triggers – PITAND

Non-infectious triggers

Pediatric Autoimmune Neuropsychiatric Disorders

Associated with Streptococcal Infections (PANDAS)

Primary infection-trigger for PANS

But there are others…

Lyme and co-infections, Mycoplasma pneumonia, EBV,

Coxsackie, Herpes 6, Herpes 1+2, CMV, Parvo B-19

5th International CEDH Conference - June 24-26, 2016

PANS (Pediatric Acute-Onset

Neuropsychiatric Syndromes)

Infectious Trigger (PITANDS

Strep

(PANDAS)

Other microbes

(Lyme, HSV 1+2,HHV-6, EBV, mycoplasma, Coxsackie, flu,

etc.)

Non-infectious Triggers

Environmental toxins

Metabolic disorders

EMF, Others

5th International CEDH Conference - June 24-26, 2016

DIAGNOSTIC CRITERIA

5th International CEDH Conference - June 24-26, 2016

KEY CLINICAL IMBALANCES IN

PANDAS/PANS/PITAND

Immune dysregulation/Autoimmune Response!!!

PANDAS – anti-DNASe B strep autoantibodies,

Moleculera Cunningham panel

Chronic infections

Toxic Exposures

Inflammation and oxidative stress

Methylation dysfunction

Mitochondrial dysfunction

Gut dysbiosis

Leaky gut with food sensitivities

5th International CEDH Conference - June 24-26, 2016

TESTING FOR PANDAS/PANS

Basic functional medicine testing PLUS:

ASO, anti-DNAse B strep antibody

Strep culture swabs (throat, anus, nose)

+/- Moleculera Cunningham panel

Other infections

Lyme and coinfections, HHV-6, HSV 1+2, EBV, Coxsackievirus

A&B, Parvo-B19, Mycoplasma, flu…

Total IgG and IgG subclasses

(Heavy metals/porphyrins)

(Mold toxicity/C4a levels)

5th International CEDH Conference - June 24-26, 2016

TREATMENT OF PANDAS/PANS

Treat the infection(s)

Pathogen-specific Antimicrobial

Abx of choice for PANDAS currently azithromycin

Control inflammation

Curcumin

NSAIDs

Steroids for flares/crisis

IVIG

Plasmapheresis

Rituximab

Modulate the immune system

Low-dose naltrexone

Specialized pro-resolving mediators

Address mitochondrial, methylation and adrenal dysfunction

5th International CEDH Conference - June 24-26, 2016

TREATMENT OF PANDAS/PANS

Remove triggers

Infection carriers, germ exposure, T&A

Environmental toxins, mold, EMF, metals

Neurologic calming agents

Theanine, Inositol

Homeopathic medicines

Medications may be necessary

Stress reduction for child AND family

Cognitive behavioral therapy

5th International CEDH Conference - June 24-26, 2016

HEALING PANDAS/PANS Firstline testing - Pathogen titers - anti-DNAse B, ASO - Lyme, mycoplasma, HHV-6, EBV HSV 1+2, Parvo B-19, CMV, coxscakie A+B - Strep cultures (throat, nose, anus) - Consider Cunninghman panel - Total IgG and IgG subclasses - Functional stool analysis - IgG food sensitivity testing - Urine organic acid testing - MTHFR or 23andme - Homocysteine, MMA - Vitamin D3, RBC Zn, RBC Mg - CBC, CMP, ferritin - Environmental IgE allergy testing

Initial Treatment Plan - ANTIMICROBIALS - ANTI-INFLAMMATORIES - Ibuprofen, Prednisone, Curcumin - Fish oil – optimize DHA - Vitamin D3 - Probiotics - GFCF diet - Whole foods, phytonutrients - Refer for CBT and other therapies

Address initial test results - Optimize nutritional deficiencies - 5 R’s for Leaky gut

Address inflammation: - Ibuprofen - Curcumin - Steroids - Consider IVIG, plasmapheresis, Rituximab

If Methylation issues: - Methyl-B12 injections - L-MTHF (methylfolate)

Address infections/triggers - Appropriate antimicrobials - Treat perianal strep - T&A - Treat all close contacts - Treat allergies - Treat environ.triggers (EMF, mold, metals)

Address immune dysfunction: - Low-dose naltrexone - Specializd pro-resolving mediators - Adrenal and mitochondrial dysfunction

ACUTE HOMEOPATHIC MEDICINES &

PANDAS

OCD/rages

Mercurius solubilis

Arsenicum album

Chamomila

Stramonium

Hysocyamus

Anxiety/fears

Argentum nitricum

Aconitum napellus

Ignatia

Pulsatilla

Phosphorous

5th International CEDH Conference - June 24-26, 2016

ACUTE HOMEOPATHIC MEDICINES

& PANDAS

Sleep disturbance

Coffea cruda

Ignatia

Hyoscyamus

Nux vomica

Tics/Choreiform movements

Tarentula

Ignatia

Lycopodium

Agaricus

Manganum aceticum

5th International CEDH Conference - June 24-26, 2016

ACUTE HOMEOPATHIC MEDICINES

& PANDAS

Bedwetting

Cina

Causticum

Equisetum

Gelsemium

Selenium (drop of urine in urethra)

Sensory issues

Zincum metallicum

Theridion

Ignatia

Fine motor regression (handwriting):

Mercurius solubilis

Medorrhinum

5th International CEDH Conference - June 24-26, 2016

USE THE NOSODE APPROPRIATELY

When “active” infection mostly resolved

Streptococcinum 15C

Syphilinum 15C

Morbilinum 15C

Etc…

5th International CEDH Conference - June 24-26, 2016

FIND THEIR CHRONIC MEDICINE

Most kids I see are Psoric or Psoro-Sycotic

Typically robust prior to getting “sick”

Waxing and waning course

Flares are BIG – like “volcanoes”

5th International CEDH Conference - June 24-26, 2016

16

PSORIC

Arsenicum album

Hepar sulphuris

Lachesis

Lycopodium

Nux vomica

Psorinum

Sulphur

Graphites

Kali bichromicum

SYCOTIC

Causticum

Dulcamara

Natrum sulph.

Medorrhinum

Nitricum acidum

Thuja occ.

Rhus tox.

Phytolacca

Hydrastis can.

TUBERCULINIC

Arsenicum iod.

Calcarea phos.

Iodum

Natrum mur.

Phosphorous

Pulsatilla

Sulphur iod.

Tuberculinum

Argentum nit.

Ignatia

Drosera

CHRONIC REACTIONAL MODES

PSORO-SYCOTIC

Silicea

Calcarea carb.

Sepia

(Graphites)

SYPHILITIC

All Flouric meds

All Mercury meds

Aurum metallicum

5th International CEDH Conference - June 24-26, 2016

5th International CEDH Conference - June 24-26, 2016

Elisa H. Song, MD

Whole Family Wellness 1601 El Camino Real, Suite 101

Belmont, CA 94002

650-595-KIDS (5437)

www.wholefamilywellness.org

Healthy Kids Happy Kids www.healthykidshappykids.com

5th International CEDH Conference - June 24-26, 2016