![\"A](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/02\/milo-2-20260205-1200x798.jpg\")
Elizabeth Bechard arm-wrestles with her son as his twin sister looks on at home in Essex on Thursday, February 5, 2026. Photo by Glenn Russell\/VTDigger<\/p>\nElizabeth Bechard arm-wrestles with her son as his twin sister looks on at home in Essex on Thursday, February 5, 2026. Photo by Glenn Russell\/VTDigger<\/p>\n
Just days before Christmas in 2023, Elizabeth Bechard\u2019s 7-year-old son woke in the middle of the night, screaming. He and his twin sister had been battling winter strep infections, Bechard said, but this was different from the discomfort of a scratchy throat and fever.<\/p>\n
In the weeks that followed, he became wracked with obsessive compulsive disorder, anxiety and rage. He refused to go to school. He shouted at his parents. He kicked walls and broke glasses.<\/p>\n
\u201cHe would become the Incredible Hulk, doing things like flipping over heavy furniture and ripping books and trying to throw himself out the window,\u201d Bechard said.\u00a0<\/p>\n
Bechard had heard about cases like this before: an otherwise content child becomes unrecognizably rageful, seemingly overnight. She had a hunch about what might be the cause. She took her son to his Burlington primary care provider, who referred them to a clinic at Dartmouth that specializes in these conditions.\u00a0<\/p>\n
It took a few months for Bechard and her son to get an appointment, but once they were there, \u201cwithin about five minutes,\u201d the doctors confirmed what she suspected, she said.\u00a0\u00a0\u00a0<\/p>\n
Her son was diagnosed with PANDAS \u2014\u00a0or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.\u00a0<\/p>\n
PANDAS, and the related PANS<\/a> (pediatric acute-onset neuropsychiatric syndrome, which has similar symptoms but no identified strep trigger) are both mysterious and controversial diagnoses that link psychological symptoms with a physiological trigger, specifically inflammation brought on by an infection, such as strep throat.\u00a0<\/p>\n The condition is marked by the sudden development of intense OCD, mood swings, rage and anxiety. Often, children refuse to eat, go to school or let their parents leave them.\u00a0<\/p>\n Researchers hypothesize that the infection triggers an autoimmune response that specifically leads to swelling in parts of the brain, which then prompts the range of psychological symptoms.\u00a0<\/p>\n Some doctors dismiss the diagnosis, instead seeing the symptoms as part of the broader spectrum of OCD and psychological disorders. They are skeptical that a virus or bacteria can cause psychological syndromes. Still others worry that the syndrome is far more widespread and underdiagnosed.<\/p>\n Clinical<\/a> studies<\/a> showing<\/a> that treating the immune system can help reduce the psychological symptoms of the condition are still early and small. But some families whose children are able to get the most intense autoimmune treatments have found it radically helps their children live with the condition. Others languish in treatment purgatory as they await coverage of the costly infusions from insurers who want to see stronger science for the therapy.\u00a0<\/p>\n One Vermont lawmaker wants to change that, forcing insurers to pay for PANDAS treatment if a doctor determines it necessary.\u00a0But that push means fighting an uphill battle of stigma and low awareness that those impacted by the disease say they\u2019ve long been mired in.\u00a0<\/p>\n A tightrope of treatment<\/p>\n \u201cThe trick is to be skeptical and open minded, which is a hard tightrope to walk,\u201d said Steven Schlozman, a doctor specializing in pediatric psychiatry at UVM Health. From his clinic, he knows that a PANDAS diagnosis is right for some patients, but he is also wary of signing a child up for the risks of treatment.\u00a0<\/p>\n Broadly, treating PANS and PANDAS aims to lessen the symptoms while also targeting the root cause. That means many children are prescribed typical treatments for psychological conditions \u2014 appetite stimulants for their food refusal, SSRIs for depression, anti-psychotics for rage \u2014\u00a0while also working through treatments that target the infection and inflammation itself.\u00a0<\/p>\n For Bechard\u2019s son, that meant taking ibuprofen and a litany of antibiotics to clear the strep infection. She said he took anti-inflammatory medication, anti-psychotics, a few different antidepressants, ADHD pills, anti-anxiety medication and steroids, too, which only worsened his psychological distress.\u00a0<\/p>\n \u201cThere\u2019s lots of trial and error for lots of different things,\u201d Bechard said.\u00a0<\/p>\n If all else fails in kicking the infection and inflammation, doctors look to an intravenous infusion of immune system antibodies for treatment of PANDAS. The treatment \u2014 called IVIG, for intravenous immunoglobulin \u2014 requires that a patient sit for hours as they receive an IV drip of someone else\u2019s donated antibodies. It is something that patients with autoimmune conditions like HIV or Lupus receive, and though the evidence is sparse, early studies have shown<\/a> it helps treat PANDAS symptoms.<\/p>\n This was the case for 12-year-old Enzo Gaskell. His story is not unlike Bechard\u2019s son\u2019s. In September 2022, Enzo had just started third grade at Christ the King School in Burlington. \u201cHe was happy as can be,\u201d his mother, Adrienne Gaskell, said.\u00a0<\/p>\n She described him as a charismatic, goofy and sociable kid. Then seemingly in a span of days or weeks, \u201che changed dramatically.\u201d\u00a0<\/p>\n Or as Enzo himself put it: \u201cOne day I went to school, and the other day, I didn\u2019t want to get out of bed,\u201d he said. \u201cIt makes me do things that I don\u2019t want to.\u201d\u00a0<\/p>\n He didn\u2019t want to eat. He didn\u2019t want to go to school \u2014\u00a0and when he did, he hid in the bathroom or disappeared in the building. He would throw things and rage at home, and he wouldn\u2019t let his parents leave him with anyone, though previously he was happy to have his grandparents over as babysitters when his parents went out on date nights.<\/p>\n It took nine months \u2014\u00a0months of meetings with pediatricians, psychiatrists, stays in and out of inpatient mental health beds and trips to the emergency room \u2014\u00a0for Enzo and his parents to even hear of PANDAS.<\/p>\n \u201cThe day we got the diagnosis was such a sense of relief to have clarity,\u201d Adrienne said. It was revelatory to have something physical and tangible to point to as the cause of this \u2014\u00a0and a clear path of treatments to target the inflammation.\u00a0<\/p>\n When antibiotics failed to address his inflammation, the Gaskells\u2019 doctors recommended IVIG therapy. Their insurance covered it.\u00a0<\/p>\n Enzo received the first infusion at home, where he could watch TV shows and sit comfortably for the hours it takes to complete the treatment. A week and half later, \u201cIt was like Enzo returned to us,\u201d Adrienne said.\u00a0<\/p>\n \u201cHe went into his room, and he was like \u2018I have to clean and organize my room,\u2019\u201d she said. \u201cIt was like he was seeing things with fresh eyes for the first time.\u201d\u00a0<\/p>\n But the treatment was not without its hiccups. Enzo said he spent the day after he had the infusion vomiting in the emergency room as his body acclimated to the influx of someone else\u2019s antibodies.\u00a0<\/p>\n Now, though, his reaction is more often a slight headache. He likes that he gets to watch \u201cThe Simpsons\u201d and drink Gatorade to hydrate after the infusions, something that would otherwise be off limits.<\/p>\n But it\u2019s side effects like those Enzo first experienced that Schlozman, the UVM Health psychiatrist, wants to prevent wrongly saddling a child with. The after effects can include allergic reactions and anaphylaxis. Often patients receive steroids with the immunoglobulins to subdue an immune response, but the steroids themselves can provoke a neuropsychiatric reaction.<\/p>\n Schlozman worries about the downsides of a child missing a day of school or sports or socializing, if other treatments can suffice. \u201cA kid\u2019s job is to be a kid,\u201d he said.\u00a0<\/p>\n Enzo, for instance, has to miss an entire day of school to receive his infusion, which he now receives every three weeks. He is able to receive the treatment at home, but that\u2019s not the case for every child.<\/p>\n \u201cIf they need it, that\u2019s great, but I certainly don\u2019t want to commit anybody if they don\u2019t need it,\u201d Schlozman said.\u00a0<\/p>\n Also, \u201cit\u2019s really, really, really, really expensive,\u201d he said.<\/p>\n Covered Condition\u00a0<\/p>\n![\"A](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/02\/milo-1-20260205-1200x798.jpg\")
Elizabeth Bechard looks on as her son and his twin sister play chess at home in Essex on Thursday, February 5, 2026. Photo by Glenn Russell\/VTDigger<\/p>\n![\"Two](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/02\/milo-5-20260205-1200x798.jpg\")
Bechard\u2019s kids play together at home in Essex on Thursday, February 5, 2026. Photo by Glenn Russell\/VTDigger<\/p>\n