Great article. PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and similar disorders such as MCAS (Mast Cell Activation Syndrome) are terrifying for parents and children. Too many doctors don't know about them.

Treatment is often an uphill battle, even to get well-understood drugs such as well-known antibiotics (such as cefprozil) and mast cell stabilizers (such as cromolyn). Many doctors refuse to try these, and many insurance companies refuse to cover them for off-book use.

In my opinion, the best solution is called "Test Of Treatment" (TOT). It means try a variety of things, and see what works. Test Of Treatment can happen after the usual treatments are tried and fail. Test Of Treatment can use generally-safe generally-reversible treatments, much like exploratory probes, to discover what's wrong and what can help.