I've read up on PANDAS a little bit. From what I have gathered is that it's basically an auto-immune condition that develops after an infection. My thoughts on this are that once your gut becomes compromised, it leaves the immune system vulnerable to other bacteria and viruses, whether initially exposed to or actively hosting. This allows the exacerbation of the gut issues which lead into the lack of enzymes produced enabling undigested food to travel through and permeate the small intestine. This in turn causes the immune system flare-up and auto-immunity of the brain.

Since many of these conditions correlate directly with Strept Throat, maybe it could be that the bacteria, that the immune system works at fighting, may somehow resemble or mimic the molecular structure of the brain so ensues the auto-immunity of the brain. So anytime that the immune system flares up due to the leaky gut and undigested food particles permeating and entering the blood stream, the immune system, now having already produced auto-antibodies not only work at getting rid of the foreign invaders but still works on attacking the brain which furthers the degeneration and worsens the tics, along with many other conditions.

Still trying to wrap my mind around all of this but what are your thoughts?