Welcome to Back from the Abyss.

I'm Dr. Craig Ecock.

Is it possible to cure anorexia and even some other psychiatric illnesses with an IV?

It turns out that in some cases, the answer seems to be yes. Today's episode is a complex

medical mystery story, and I'll need to give you all some background before we dive into it so

you understand what's happening. There's a growing awareness in psychiatry that not all

psychiatric illness is psychiatric. Some percentage of what we see in our offices is actually

triggered by autoimmune responses to various pathogens and insults.

Back in my residency 24 years ago, we learned about the recently discovered syndrome called

pandas, pediatric, autoimmune, neuropsychiatric disorders associated with strep.

Now, these were cases of sudden OCD or ticks that appeared in conjunction

with strep infections. The theory was that parts of the basal ganglia of the brain had exterior

cell proteins, which were very similar to those of the proteins on the strep bacteria.

And as the immune system began to attack the strep bacteria, it also began an autoimmune

assault on parts of the midbrain, including the basal ganglia, thus producing a sudden onset

of OCD or tick disorder.

Now, in recent years, Pandas has evolved into a broader concept called PANS,

pediatric acute onset neuropsychiatric syndrome, which includes a vast array of neurological

and psychiatric symptoms and syndromes, which can potentially be triggered by

autoimmune reactions.

Now, it can be tricky to diagnose pants, and this is probably why it's still somewhat controversial

in some areas of psychiatry.

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