Why does neuroinflammation look different as children grow? In this episode of Demystifying PANS/PANDAS, pediatric neurologist Dr. John Gaitanis explains the continuum of neuroinflammation, why regression represents loss of brain function, and how energy metabolism, immune activation, and the cell danger response shape symptoms across childhood and adolescence.

Regression isn’t loss without cause. It’s the brain conserving energy under inflammatory pressure. In this episode of Demystifying PANS/PANDAS, Dr. John Gaitanis reframes autism regression, PANS/PANDAS, and chronic fatigue as points along a continuum of neuroinflammation rather than separate diagnoses.

He explains how repeated inflammatory and infectious stressors can lock the brain into a low-energy survival state known as the cell danger response, disrupting development, behavior, and learning. We also explore cerebral folate deficiency, mitochondrial stress, autonomic dysfunction, and why true recovery takes time, physiologic regulation, and individualized care, not symptom suppression alone.

Dr. John Gaitanis is a pediatric neurologist who cares for children and adolescents with complex neuroimmune and neuroinflammatory conditions, including developmental regression, PANS/PANDAS, seizures, chronic fatigue, and dysautonomia. By following patients over decades, he has developed a clinical perspective that connects these diagnoses along a single continuum rather than treating them as isolated disorders.

In this conversation, Dr. Gaitanis shares how concepts like cerebral folate deficiency, mitochondrial energy demand, autonomic imbalance, and the cell danger response help explain why symptoms change with age, and why restoring physiologic balance is essential for recovery.

Dr. John Gaitanis

Website: brainfoundation.org/brain-investigators/brain-pi-john-gaitanis/

MAPS: medmaps.org/faculty/john-gaitanis/

Nancy O’Hara, MD, MPH, FAAP, FMAPS

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