Homeopathy for PANDAS

 In Homeopathy, Pediatrics

Naturopathic Perspective
Angelica Lemke, ND

I specialize in the homeopathic treatment of children’s chronic illnesses, and during the past year I have successfully treated many cases of PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections). My approach to PANDAS generally involves finding the best constitutional remedy for the child and dosing that remedy intercurrently with isopathic preparations of specific Streptococcus strains.

While PANDAS lacks official diagnostic criteria, these children tend to have a rapid onset of obsessive-compulsive symptoms or tic disorders caused by an autoimmune reaction to Streptococcus. In addition, they have a rapid increase in emotional lability, enuresis, and anxiety, as well as deterioration in cognitive abilities such as handwriting. There may be family history of chronic strep throat or rheumatic heart disease. Children suspected of PANDAS may or may not test positively on Streptococcus cultures, but a presumptive “diagnosis” can be made when children’s symptoms improve upon treatment with antibiotics, which usually extends into long-term, prophylactic antibiotic use.

Parents come to me when they want a more natural approach than antibiotics for treating their children. While I do see a wide variety of symptom pictures, around 50% of my cases have a presentation that responds well to a prescription of either Ignatia or Carcinosin (and sometimes they move between these 2). These remedies are known for suppression of both the emotions and the immune system, which may account for their ability to help when Streptococcus has been suppressed deep within the neurological system. Other common prescriptions include Anacardium, Sulphur, China, Aconite, and Lac caninum.

The Streptococcus nosode has been proven and is well described in materia medica. There seems to be a strong overlap in the general picture of the Streptococcus nosode and Ignatia, and I have found that in many of my PANDAS cases there is an element of repressed grief. Physical manifestations of Streptococcus include frequent sore throats, upper respiratory tract infections, urinary tract infections, acne, otitis media, dental caries, sinusitis, and eye fatigue. Although various strains of Streptococcus are available at homeopathic pharmacies, most PANDAS cases respond well to homeopathic Streptococcus pyogenes or a combination preparation called Streptococcinum. The following case demonstrates the intercurrent use of Ignatia and Streptococcinum.


Philip (7 years old) is a neurotypical boy who is a high achiever in school. His mother says, “He began having nervous tics and fears as well as obsessions a few years ago. Antibiotics helped to some degree but did not hold for very long. PANDAS is interfering with his life and stopping him from living the kind of life a boy should.” He is obsessed with hand washing, and tics include a clicking sound made in the throat, eye blinking, and twisting his neck to the side. He does his best to control the tics at school, but they emerge when he comes home. His mother describes his emotions thus: “Overwhelmed, rejected, not worth being heard what his feelings are, and this provokes a rage, like you don’t want to lose control but you can’t help yourself. He pushes me (his mother) away and says ‘don’t talk to me.’ His breathing feels high up; his heart feels closed up. He is hard on himself and has high expectations of himself.”

This case was a strong presentation of Ignatia, which was prescribed in 1M potency to be taken once a week. Streptococcus pyogenes 1M was given intercurrently once a week. With close follow-up, Philip’s case resolved within 3 months, to the point where he no longer had tics or emotional lability and his self-confidence was restored.

While some patients respond to less frequent dosing, in cases of suppression I give the remedy more often and in high potencies. I will also teach the parents to redose the remedies if they see symptoms of a PANDAS flare such as a temper tantrum or an increase in tics. I look for amelioration of symptoms within the first week of treatment; however, the long-term process of healing on the deepest levels can take many months and diligent follow-up. Sometimes healing is a bumpy road; when remedies are dosed, tics can get worse, and intense emotional “confessions” may surface. This is fine as long as the parents understand the process.

In the long run, pharmaceutical treatment of Streptococcus or chronic immune deficiency can lead to the suppression or penetration of Streptococcus deep into the neurological system. Eventually, upon encountering a pathogen, these children begin to manifest temper tantrums and tics instead of typical colds and flus. Homeopathic treatment helps reestablish a healthy response to these infections, harmonize the immune system, and release suppression.

Angelica_Lemke_headshotAngelica Lemke, ND is a graduate of Bastyr University (Kenmore, Washington) and Georgetown University (Washington, DC). She has been a speaker at the Autism One convention and the National Autism Association convention and has a large international clientele spanning 15 countries. Most of her consultations are done via Skype. E-mail: [email protected]

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