1. PEDIATRIC
AUTOIMMUNE
NEUROPSYCHIATRIC
DISORDERS ASSOCIATED
WITH STREPTOCOCCAL
INFECTIONS
Relieving PANDAS symptoms in Children with
Non-invasive Electro-Stimulation
Anna Bezprozvanny, Avazzia Inc.
Dr. Cynthia Keller M.D.
Angela Zappone RDH, Avazzia Clinician
Protocol created by:
Pamela Shaw, PhD
Michael E. DeBakey,
Veterans Affairs Medical
Center
Stanley Wolfe, DVM
Private Practice
2007

2. Objectives
Microcurrent electrical stimulation for pain
has been researched and reported effective
in a number of recent studies. The purpose
of this preliminary study is to document
educational training modules in the use of
Avazzia technology for reducing post
PANDAS episodes in children. Self-
reported intensity of symptoms and
frequency of symptoms were measured and
reported indicating effectiveness of the
microcurrent therapy using the Avazzia
PRO-SPORTTM device, a non-invasive
hand-held microcurrent device that utilizes
microchip and interactive technology to
produce an electrical current with the skin as
a conduit, cleared by the US FDA for
treating pain.
Overview
Overview Results
All participants reported positive feedback
and the best results were observed 3-5
weeks after the initial start of treatment. The
average intensity of symptoms was reduced
by 40.3% while the average frequency of
symptoms was reduced approximately 34%.
Introduction:
PANDAS, “Pediatric Autoimmune
Neuropsychiatric Disorders Associated with
Streptococcal Infections”, is used to describe
children who have OCD (Obsessive
Compulsive Disorder) and other tics
associated with Tourette syndrome. These
symptoms worsen after a child has strep
infections, and the National Institution of
Mental Health are pursuing a theory on the
development of this disease.1 The theory
states that the body’s attempt to produce
antibodies in response to the strep infection
are actually the result of “molecular
mimicry”. This is when the cell walls of the
bacteria similarly resemble the cell walls of
vital organs, and in turn the antibodies attack
heart valves, joint, and/or certain parts of the
brain. Explicitly in PANDAS, the antibodies
created attack the specific part of the brain,
Basal Ganglia, which is hypothesized to
control the movement and behavior of the
individual. With the negative interactions of
antibodies in the brain, a series of tics and/or
OCD symptoms occur. In addition to a
child’s OCD and/or tics associated with
PANDAS, other indications can result.
These can vary from ADHD symptoms,
separation anxiety, mood changes, and sleep
disturbance to more physical disturbances
including motor changes and joint pain.2
PANDAS is a rare disease diagnosed in
.005% of the children population.2 These
conditions cannot be apparent in adults or
adolescents due to it being a pediatric
disorder, therefore the current research
targeted to PANDAS is limited to only
children. Though, there is a possibility that
older ages may have an immune mediated
OCD.
The primary treatment of PANDAS is
cognitive behavioral therapy and
medication. Usually, treatments focus on
stabilizing OCD symptoms, with the use of
fluoxetine and SSRI (serotonin reuptake
inhibitor).1 Some PANDAS patients
undergo treatment to eliminate the strep
infection with penicillin, amoxicillin,
azithromycin, and other antibiotics. More
extreme measures dealing with the immune
responses is the injection of steroids,
immunoglobulin, and plasmapheresis.
While, some children completely recover
from PANDAS, others will experience
reoccurrences sometimes with worsening
symptoms. There is no certain way of
predicting which children will be affected,
but the current main goal of therapy is to

3. attack OCD/tics and to limit the interference
in daily life.
Low frequency microcurrent therapy was
applied to patients with post PANDAS
episodes associated with anxiety, stress, and
PTSD. Children that suffer from these
conditions cannot endure acupuncture which
is typically used to relieve such symptoms.
The patients undergo 10 different sessions
ranging from 30-45 minutes of noninvasive
microcurrent electrical stimulation. These
sessions move throughout different
acupunctural points and are well tolerated by
the children. Along with the addition of a
relaxing environment consisting soft light
and music, the patients instantly begin to
feel calmer.
An open-label clinical study to evaluate
effectiveness for treating post PANDAS
episodes with the Avazzia Pro-SportTM
microcurrent neurostimulator was
conducted. In this study low frequencies of
microcurrent was applied.
Microcurrent is often compared to TENS
(transcutaneous electrical nerve stimulation)
technology. Some TENS applications are
designed to saturate nerves, thus blocking or
preventing pain signals to the brain. These
types of TENS are often effective for acute
injuries, but becomes ineffective once the
patient’s body accommodates or habituates
to the signal. Instead, microcurrent
technology found in Avazzia PRO-
SPORTTM devices incorporates advanced
TENS technology with the use of low-level
electrical currents and interactive feeback
technology to treat nerve and muscle pain,
and other chronic health challenges.3
Methods
For each participant, the clinician
administered treatment protocol created by
Michael E. DeBakey and Stanley Wolfe
addressed nerve regions and acupuncture
points. Each treatment was repeated once a
week for 10 weeks:
1. Vagus Nerve and Sternocleidomastoid
Muscle Treatment also known as “Little
Wings”. The area behind the ear where the
sternocleidomastoid muscle attaches to the
mastoid bone near the scalene muscle was
stimulated causing a mild muscle
contraction. The PRO-SPORTTM was set to
the acute mode and completed 5 cycles on
this region.
2. Kidney 5 and Spleen 9. A red pad was
attached to the inner right foot area located
on the calcaneus bone (Kidney 5), while a
second black pad was placed in the
depression posterior and inferior to the
medial condyle of the tibia (Spleen 9). These
acupuncture points were attached to the
PRO-SPORTTM and set to the stimulate
mode for 3-5 minutes.
3. Liver 13 and Pericardium 6 Inner Pass.
Two black pads were placed symmetrically
on the lower abdomen (Liver 13), while one
red pad was placed on each lower wrist
between the radius and ulna (Pericardium 6).
The Avazzia device was set to the stimulate
mode for 3-5 minutes.
4. Stomach 7 and Bladder 11. One black pad
was placed on the zygomatic on the right
side and a red pad was placed on the
zygomatic on the left side (Stomach 11).
The second black pad was placed on the
opposite infraspinatus area, as the red pad
was also placed on the opposite
infraspinatus area (Bladder 11). The

4. microcurrent was set to the stimulate mode
for 3-5 minutes.
5. Governing Vessel 15 Mutes Gate and
Governing Vessel 3 Lumbar Yang Pass. One
red pad was placed on the cervical vertebra
(Governing Vessel 15 Mutes Gate), while a
black pad was placed on the sacrum
vertebrae. The mode of the PRO-SPORTTM
was set to stimulate for 5-10 minutes.
Recording Results
At the end of the visit, the patients detailed
their current pain level by rating on a
numerical visual analog scale (VAS) from 0
to 5 on intensity and frequency. Pain scores
post-treatment were collected approximately
5 to 10 minutes after the end of the treatment
session.
Results
With the seven patients that completed the
administered treatment protocol, 100% of
patients reported a reduction in pain
intensity, and 100% of patients reported a
reduction in pain frequency.
Clinical Findings
Of the seven patients who completed the
protocol and treatment, the cumulative scores for
intensity of symptoms started at 176 and
dropped to 105. At the end of the study the
intensity of symptoms decreased 71 points or
40.3%. These seven patients also originally
scored intensity of frequency amassed at 193
points and decreased to 127 points (by 33.9%).
Discussion
This study investigated the effectiveness of
microcurrent technology using the Avazzia
PRO-SPORTTM
device as a treatment on post
PANDAS symptoms. Though, pain is not a
primary PANDAS symptom, so there was no
use of a VAS pain scale but instead the
evaluation of each symptom: intensity and
frequency. This conducted study was limited to
only children due to it being a Pediatric
Autoimmune disorder.
Recommendations
Even though overall results were positive, and
every participant received relief, further study
would be beneficial.
Future studies may consider
- Identify and specify what determines a non-
significant change versus significant change for
each measurement so that non-significant
changes are not counted as either positive or
negative if the change was non-significant.
-Identify a way to confirm data measurements.
-Increased number or participants.
Summary/Conclusion
The Avazzia PRO-SPORTTM
safely and
effectively improved PANDAS symptoms in
children. All children in the study exhibited
symptoms such as headaches,muscle tension
and pain in shoulders/neck, therefore all protocol
was compliant with FDA guidelines. Not only
did intensity of symptoms decrease 40.3% and
intensity of frequency 33.9%, but the patients
continued to come in when under stress and
sustained improvement. Every child and parent
noticed a significant improvement and ability to
cope with PANDAS symptoms.

5. REFERENCES
1. "PANDAS:Frequently Asked
Questions about Pediatric Autoimmune
Neuropsychiatric Disorders Associated
with StreptococcalInfections." NIMH
RSS. The National Institute of Mental
Health. Web. 18 Mar. 2015.
<http://www.nimh.nih.gov/health/public
ations/pandas/index.shtml>.
2. "PANDAS (Pediatric Autoimmune
Neuropsychiatric Disorders Associated
With Streptococcal Infections)
Symptoms, Causes,Treatment - What Is
the Treatment for PANDAS? -
MedicineNet." MedicineNet. Web. 18
Mar. 2015.
<http://www.medicinenet.com/pandas/p
age3.htm#what_is_the_prognosis_of_pa
ndas>.
3. Whitaker, Julian, MD. “What is
Microcurrent Therapy?” Dr. Julian
Whitaker. 14 Feb 2014. 23 March 2015.
http://www.drwhitaker.coom/what-is-
microcurrent-therapy.