Post infectious neuro-psychiatry disorders

Post infectious neuro-psychiatry disorders are characterized by abnormal changes in neurological function, behaviour, and mood which occur as a result of an infection which triggers an autoimmune response targeting the brain.

Causes

The causes of post infection neuropsychiatric disorders include bacterial infections as in paediatric autoimmune neuropsychiatric disorders associated with streptococcus infections (PANDAS), viral infections such as herpes or measles, and parasitic infections.    

Impact

The child may begin to show personality changes with a decline in math and handwriting skills. In some children, the condition can be very debilitating and they become homebound.

Symptoms

Symptoms of post infectious neuro-psychiatric disorders include:

  • Obsessive compulsive disorder
  • Severe anxiety
  • Migraines
  • Depression
  • Irritability and aggression
  • Sensory sensitivities
  • Age regression
  • Hallucinations

Stages

The symptoms usually have an acute onset, but may have been present in a milder form for weeks or years.

Diagnosis

A clinical diagnosis is made based on an association with a recent infection and the presence of neuro-psychiatric symptoms that cannot be explained by a neurological or medical disorder. Your child's doctor may order diagnostic studies such as an MRI or EEG to rule out other conditions. Antibody testing may also be ordered to identify the pathogenic organism.

Untreated

If left untreated, the debilitating symptoms may increase over a period of weeks and months until permanent cognitive damage occurs.

Treatment-options

The condition generally shows dramatic improvement with antibiotics within a week. However, obtaining a complete cure may require prolonged antibiotics for months to a year and other treatments such as intravenous immunoglobulin or plasmapheresis.

  • Australian Medical Association (AMA)
  • Royal Australasian College of Physicians, Australia (RACP)
  • Australian and New Zealand Child Neurology Society, Australia (ANZCNS)
  • Epilepsy Society of Australia (ESA)
  • International League Against Epilepsy (ILAE)
  • International Child Neurology Association (ICNA)