When Neurodevelopmental Symptoms Start in the Womb

When Neurodevelopmental Symptoms Start in the Womb

What if a child's neuroinflammation began long before the first symptoms appeared? In this episode of Demystifying PANS/PANDAS, Dr. Somer DelSignore joins us to speak about congenital vector-borne infections and how in utero exposure to pathogens and maternal immune activation may influence brain development, immune programming, and later neuropsychiatric or developmental challenges. They explore why pregnancy timing matters, which early signs may raise suspicion, why negative testing does not always rule out transmission, and how hidden infectious burdens can sit beneath labels like PANS, autism, or autoimmune encephalopathy. Dr. DelSignore also shares the thinking behind her RESET Protocol and why lasting recovery often requires addressing inflammation, infections, gut health, toxins, detoxification, and nervous system support together. - - - - - About the Guest: Dr. Somer DelSignore, DNP, BC-PNP, FMAPS, ILADS, FAAOT is a board-certified child and adolescent provider known for her expertise in diagnosing and managing complex chronic illness in children. She is the CEO and founder of Hudson Valley Integrative Health and has developed the RESET Protocol, a root-cause framework designed to address immune dysfunction systematically. She is a fellow at MAPS and AAOT, a member of ILADS, and has deep experience in autoimmune and neuroimmune conditions, along with the psychiatric manifestations of infectious disease, especially tick-borne infections. Dr. DelSignore earned her Master of Nursing Practice from the University of Pennsylvania and her Doctor of Nursing Practice from SUNY Upstate Medical University, and completed residencies at CHOP, Penn State, and Children's Health in Dallas. - - - - - Hopewell is a family-owned pharmacy which has been in existence since 1987. You can call them at 800-792-6670, email them at info@hopewellrx.com [info@hopewellrx.com] or visit them online at www.hopewellrx.com [https://www.hopewellrx.com/]. Hopewell Pharmacy: Your partner in integrative wellness. Other Links for the Guest: Website: https://hudsonvalleyintegrativehealth.com/ [https://hudsonvalleyintegrativehealth.com/] LinkedIn: https://www.linkedin.com/in/somerdelsignorekidslyme/ [https://www.linkedin.com/in/somerdelsignorekidslyme/] - - - - - Nancy O’Hara, MD, MPH, FAAP, FMAPS Website: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drohara.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.drohara.com/] Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/drnancyohara/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.facebook.com/drnancyohara/] Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/nhoharamd/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.instagram.com/nhoharamd/] LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/nancy-o-hara-md-mph-faap-390781258/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.linkedin.com/in/nancy-o-hara-md-mph-faap-390781258/] Join our listeners on ⁠⁠⁠Spotify⁠⁠⁠ [https://open.spotify.com/show/5OG5m0bbFZaOIoEt09ZgZq?si=1c0f02723a6b4940], ⁠⁠⁠Apple Podcasts⁠⁠⁠ [https://podcasts.apple.com/fi/podcast/demystifying-pans-pandas-podcast/id1798735991], and ⁠⁠⁠iHeart Radio⁠⁠⁠ [https://www.iheart.com/podcast/269-demystifying-pans-pandas-p-269037888/]. - - - - - PODCAST Thank you for listening. Please subscribe and share. This podcast is produced by DrTalks.com https://drtalks.com/podcast-service/ [https://drtalks.com/podcast-service/]

How Parents Can Stop Feeding the Worry Loop

Sometimes the behaviors families rush to fix are actually part of a larger anxiety loop happening inside the home. In this episode of Demystifying PANS/PANDAS, Dr. Nancy O’Hara speaks with Dr. Sarah Bren about why therapy can be such a powerful and flexible tool for anxious children, and how the SPACE model helps parents shift patterns that may be unintentionally maintaining symptoms. They discuss the difference between reducing anxiety and building tolerance for it, why reassurance and accommodations can keep children dependent on rescue, and how supportive statements help kids feel both safe and capable. Dr. Bren also explains how this work applies not only to anxiety and OCD, but also to emotional dysregulation, sibling dynamics, and family systems where one or both parents feel stuck in opposite roles. - - - - - About the Guest: Dr. Sarah Bren is a clinical psychologist, mom of two, and the co-founder and clinical director of Upshur Bren Psychology Group in Pelham, New York. She has dedicated her career to translating the science of attachment into simple, real-life strategies that support children's development while also protecting parental mental health. She is also the host of the parenting podcast Securely Attached, a top-ranked show focused on pregnancy, toddlerhood, adolescence, and everything in between. Through her clinical work, parenting resources, and integrative therapeutic approach, Dr. Bren helps families navigate anxiety, attachment, and emotional challenges with clarity, compassion, and practical tools. - - - - - 🎧 Securely Attached Podcast Helping parents navigate the emotional side of raising children, this show blends psychology, attachment theory, and practical strategies to foster resilience and connection. Each episode offers grounded insights that empower families to build stronger bonds and nurture healthy development. * Listen on Spotify [https://open.spotify.com/show/531wXyPuHcjejeUwE0K6iX?si=5635231443e14b1c] * Listen on Apple Podcasts [https://podcasts.apple.com/us/podcast/securely-attached/id1570870737] Websites: https://upshurbren.com/ [https://upshurbren.com/], https://drsarahbren.com/ [https://drsarahbren.com/] - - - - - Nancy O’Hara, MD, MPH, FAAP, FMAPS Website: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drohara.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.drohara.com/] Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/drnancyohara/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.facebook.com/drnancyohara/] Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/nhoharamd/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.instagram.com/nhoharamd/] LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/nancy-o-hara-md-mph-faap-390781258/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.linkedin.com/in/nancy-o-hara-md-mph-faap-390781258/] Join our listeners on ⁠⁠Spotify⁠⁠ [https://open.spotify.com/show/5OG5m0bbFZaOIoEt09ZgZq?si=1c0f02723a6b4940], ⁠⁠Apple Podcasts⁠⁠ [https://podcasts.apple.com/fi/podcast/demystifying-pans-pandas-podcast/id1798735991], and ⁠⁠iHeart Radio⁠⁠ [https://www.iheart.com/podcast/269-demystifying-pans-pandas-p-269037888/]. - - - - - PODCAST Thank you for listening. Please subscribe and share. This podcast is produced by DrTalks.com https://drtalks.com/podcast-service/ [https://drtalks.com/podcast-service/]

Bartonella and PANS: What Clinicians and Families Need to Know

What if Bartonella is part of the reason some children with PANS remain stuck in cycles of rage, confusion, sleep disruption, and chronic neuropsychiatric symptoms? In this episode of Demystifying PANS/PANDAS, we speak with Dr. Ed Breitschwerdt about why Bartonella deserves much more attention in the PANS world—and why the term 'vector-borne disease' is often more accurate than simply saying Lyme. We discuss the broad range of vectors that may transmit Bartonella, why symptom overlap makes diagnosis difficult, the significance of striae-like skin lesions, and why standard tests often miss infection. Dr. Breitschwerdt also explains how Bartonella can persist in tissues, why triple-draw and molecular testing may improve detection, and why chronic infection, inflammation, and immune dysfunction need a much bigger research response. - - - - - About the Guest: Dr. Ed Breitschwerdt, DVM, DACVIM, PhD is a professor of medicine at North Carolina State University College of Veterinary Medicine, a professor at Duke University, and co-founder of Galaxy Diagnostics. He is a leading expert in Bartonella and vector-borne infectious diseases, with decades of research spanning both animal and human health. A veterinary internist and infectious disease researcher, Dr. Breitschwerdt has authored hundreds of peer-reviewed publications and helped redefine Bartonella as a cause of persistent infection, neurologic disease, and neuropsychiatric illness. His work emphasizes the need for more sensitive diagnostics and expanded research into chronic infection and immune dysfunction. - - - - - Social Handles: Website: https://www.galaxydx.com/ [https://www.galaxydx.com/]; https://cvm.ncsu.edu/people/ebbreits/ [https://cvm.ncsu.edu/people/ebbreits/] Facebook: https://www.facebook.com/galaxydx [https://www.facebook.com/galaxydx] Instagram: https://www.instagram.com/galaxydiagnostics/ [https://www.instagram.com/galaxydiagnostics/] LinkedIn: https://www.linkedin.com/company/galaxy-diagnostics-inc-/ [https://www.linkedin.com/company/galaxy-diagnostics-inc-/] YouTube: https://www.youtube.com/@GalaxyDiagnosticsVideos [https://www.youtube.com/@GalaxyDiagnosticsVideos] Explore A Blind Spot on Autism — a powerful resource that challenges misconceptions and brings clarity to the autism journey. Learn more today at ablindspotonautism.com [https://ablindspotonautism.com/]. - - - - - Nancy O’Hara, MD, MPH, FAAP, FMAPS Website: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drohara.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.drohara.com/] Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/drnancyohara/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.facebook.com/drnancyohara/] Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/nhoharamd/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.instagram.com/nhoharamd/] LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/nancy-o-hara-md-mph-faap-390781258/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.linkedin.com/in/nancy-o-hara-md-mph-faap-390781258/] Join our listeners on ⁠Spotify⁠ [https://open.spotify.com/show/5OG5m0bbFZaOIoEt09ZgZq?si=1c0f02723a6b4940], ⁠Apple Podcasts⁠ [https://podcasts.apple.com/fi/podcast/demystifying-pans-pandas-podcast/id1798735991], and ⁠iHeart Radio⁠ [https://www.iheart.com/podcast/269-demystifying-pans-pandas-p-269037888/]. - - - - - PODCAST Thank you for listening. Please subscribe and share. This podcast is produced by DrTalks.com https://drtalks.com/podcast-service/ [https://drtalks.com/podcast-service/]

Mouth Breathing Is a Red Flag Parents Shouldn’t Ignore

What if sleep, feeding struggles, and behavioral changes all traced back to how a child breathes? In this episode of Demystifying PANS/PANDAS, Dr. Nancy O’Hara speaks with pediatric occupational therapist Bri Kurcsak about why airway health, tongue function, and sleep quality are often the missing pieces in children struggling with regulation, eating, and recovery. - - - - - About the Guest: Bri Kurcsak, MS, OTR/L, is a pediatric occupational therapist with over 19 years of clinical experience and advanced training in infant and child feeding, pediatric pelvic floor therapy, sensory-motor development, and wellness related to nutrition and sleep. She is the founder and lead clinician of Flourish Carolina, a pediatric private practice in Charlotte, North Carolina, where she provides integrative, whole-child care for children and families. Bri lectures nationally for organizations including MAPS and TACA and is deeply committed to interdisciplinary education and collaboration. She has served as adjunct faculty and continues teaching future occupational therapists while helping providers and families better understand the critical role of airway, sleep, and feeding in pediatric healing. - - - - - Social Handles: Website: https://www.flourishcarolinaot.com/ [https://www.flourishcarolinaot.com/] Instagram: https://www.instagram.com/curious_fork/ [https://www.instagram.com/curious_fork/] - - - - - Nancy O’Hara, MD, MPH, FAAP, FMAPS Website: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drohara.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.drohara.com/] Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/drnancyohara/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.facebook.com/drnancyohara/] Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/nhoharamd/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.instagram.com/nhoharamd/] LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/nancy-o-hara-md-mph-faap-390781258/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.linkedin.com/in/nancy-o-hara-md-mph-faap-390781258/] Available on Spotify [https://open.spotify.com/show/5OG5m0bbFZaOIoEt09ZgZq?si=1c0f02723a6b4940], Apple Podcasts [https://podcasts.apple.com/fi/podcast/demystifying-pans-pandas-podcast/id1798735991], and iHeart Radio [https://www.iheart.com/podcast/269-demystifying-pans-pandas-p-269037888/]. - - - - - PODCAST Thank you for listening. Please subscribe and share. This podcast is produced by DrTalks.com https://drtalks.com/podcast-service/ [https://drtalks.com/podcast-service/]

Gut Metabolites and the Brain: What Autism Research Is Revealing

The biggest driver of brain symptoms might be what’s happening in the gut. In this episode of Demystifying PANS/PANDAS, we are joined by Dr. James Adams to talk about microbial metabolites, hidden yeast and bacterial issues in autism, a new urine-based metabolite test, and why microbiota transplant therapy may improve mood, sleep, and behavior by restoring microbial balance. - - - - - About the Guest: Dr. James Adams is a professor at Arizona State University and a leader in its autism research program, with decades of work focused on identifying biological contributors to autism and advancing evidence-based interventions. His path into the field began after his daughter was diagnosed with severe autism and intellectual disability, motivating his pursuit of research aimed at understanding root causes rather than managing symptoms alone. His research explores gut dysbiosis, yeast and bacterial overgrowth, microbial metabolites, and microbiota transplant therapy, with ongoing efforts to develop practical diagnostic tools and refine treatment approaches through clinical studies. - - - - - Social Handles: Website: http://www.adamsautismresearch.com/ [http://www.adamsautismresearch.com/] - - - - - Nancy O’Hara, MD, MPH, FAAP, FMAPS Website: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.drohara.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.drohara.com/] Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/drnancyohara/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.facebook.com/drnancyohara/] Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/nhoharamd/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.instagram.com/nhoharamd/] LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/nancy-o-hara-md-mph-faap-390781258/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ [https://www.linkedin.com/in/nancy-o-hara-md-mph-faap-390781258/] - - - - - PODCAST Thank you for listening. Please subscribe and share. This podcast is produced by DrTalks.com https://drtalks.com/podcast-service/ [https://drtalks.com/podcast-service/]