Emily Simpson's Tough Decision: Navigating Son Luke's PANDAS Treatment

The Real Housewives of Orange County star Emily Simpson is still searching for answers as her son Luke continues to be treated for PANDAS and ARFID. “I don't know if Luke's any better. We're still dealing with a lot of the same issues, and we've tried a couple things,” Emily, 50, exclusively shared with Us on Friday, August 14, while promoting season 20 of the Bravo reality show. “I don't know if they're working, and that's hard for me as a mom because I want to fix everything.” During the season 19 premiere of RHOC in July 2025, Emily revealed her 11-year-old son was diagnosed with avoidant restrictive food intake disorder (ARFID). According to the Cleveland Clinic, ARFID is a condition that limits a person’s food intake. Those facing the eating disorder can lose interest in eating, feel anxious about the consequences of eating and avoid foods that have an unwanted color, taste, texture or smell.

After sharing her son’s story, Emily received helpful recommendations from viewers who suggested further tests. Luke was later also diagnosed with PANDAS, a group of autoimmune neuropsychiatric disorders associated with strep throat.

“I go back and forth between continuing and trying to find different therapies for him, or just [thinking] Luke is Luke, and maybe he doesn't need therapy or IVIG treatment,” Emily explained to Us. “Maybe he just needs to be Luke, and that's hard sometimes to figure out if I'm doing the right thing and making the right choices when it comes to him.” Last year, Emily — who also shares daughter Annabelle, 13, and son Keller, 11, with husband Shane Simpson — confirmed to Us that Luke underwent a laser brain procedure. When asked about the treatment on Friday, the reality star said she is unsure whether it made much of a difference. “We tried IVIG therapy, which is an infusion of antibodies. It takes about six hours. He actually had to sit on a couch, and a nurse came over, did an infusion,” Emily recalled. “You're supposed to do six sessions of that. We only did one so far, and I'm at a point where I don't know if I want to continue on with the rest of the infusions or not. That’s a hard place for me to be in right now.” Luke had some “severe reactions” to the treatment, including migraines and nausea, so Emily is questioning what to do next.