CHSU Discovery

Abstract

PANDAS is an acronym for ‘pediatric autoimmune neuropsychiatric disorders associated with
streptococcal infections’ and is defined as a subgroup of PANS, ‘Pediatric acute-onset
neuropsychiatric syndrome’. Diagnosis must have 1) Abrupt onset or abrupt recurrence of OCD or
Restrictive Eating Disorder 2) Co-morbid neuropsychiatric symptoms (at least 2) with a similarly
acute onset: anxiety, sensory amplification or motor abnormalities, behavioral regression,
deterioration in school performance, mood disorder, urinary symptoms and/or sleep disturbances. 1
• PANS is a clinical diagnosis given to children who have a dramatic – sometimes overnight – onset
of neuropsychiatric symptoms and the cause is thought to be triggered by infections, metabolic
disturbances, and other inflammatory reactions.
• PANDAS is a disorder of acute onset with obsessive-compulsive disorder and/or tics in children
following a group A streptococcal infection, often with other behavioral or cognitive symptoms,
including irritability and separation anxiety. Like PANS, the onset is often dramatic, with both
psychological symptoms and physical symptoms happening within 48 to 72 hours to weeks. 2
• Symptoms of PANDAS overlap with those of many psychiatric and medical conditions; most
children experience a relapsing and remitting course, and some have persistent difficulties that last
through childhood and into their adolescence. 6
• Since PANDAS is a diagnosis of exclusion, a thorough psychiatric and medical evaluation is
necessary to make the correct diagnosis and institute appropriate treatment. Its diagnosis is made in
which symptoms are not better explained by a known neurologic or medical disorder. 2
• Treatment of PANDAS should involve a 3-pronged approach: psychiatric/behavioral treatment,
immunomodulatory therapies, and antimicrobial treatment. 3