Tillie Doyle
PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) is a clinically defined disorder characterised by the sudden onset of obsessive-compulsive symptoms (OCD) or eating restrictions, along with acute behavioural deterioration in at least two designated domains. PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is a subset of PANS and is specifically associated with an infection from streptococcal (strep) bacteria. While PANS and PANDAS typically first appear in childhood, it is possible, though uncommon, for adults to develop these conditions.
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What You'll Learn
- PANS and PANDAS are episodic disorders, meaning symptoms may disappear and then reappear
- PANS is caused by infections, metabolic disturbances, inflammatory reactions, or environmental factors
- PANDAS is a subset of PANS and is specifically associated with streptococcal (strep) bacteria
- Antibiotics can cure a current strep infection and prevent new ones
- Adults can be diagnosed with PANDAS or PANS, although it is rare
PANS and PANDAS are episodic disorders, meaning symptoms may disappear and then reappear
PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) is a clinically defined disorder characterized by the sudden onset of obsessive-compulsive symptoms (OCD) or eating restrictions, along with acute behavioural deterioration in at least two designated domains. PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is a subset of PANS and was first reported by a team at the National Institute of Mental Health in 1998. PANDAS syndrome describes a group of symptoms, such as tics and obsessive-compulsive behaviour, thought to affect certain children who have had strep infections.
PANDAS is an autoimmune condition that occurs following an infection with Group A Streptococcus (strep). PANDAS is the only subtype of PANS that requires that symptoms be associated with a strep infection. PANS has been reported to occur in association with a variety of infectious agents, including influenza, varicella, and mycoplasma pneumoniae. Lyme disease has also been proposed as a trigger for neuropsychiatric symptoms.
While PANS and PANDAS typically first appear in childhood, it is possible for adults to develop these conditions. Antibiotics can cure the current strep infection and prevent new infections while calming the autoimmune processes affecting the brain. However, there is insufficient evidence to recommend the long-term use of antibiotics.
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PANS is caused by infections, metabolic disturbances, inflammatory reactions, or environmental factors
While PANDAS and PANS are more prevalent in children, adults can also be diagnosed with these conditions. PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome, is a clinical diagnosis given to children who exhibit a dramatic and sudden onset of neuropsychiatric symptoms, including obsessions, compulsions, or food restriction. PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections, is a type of PANS caused by a strep infection.
The cause of PANS is unknown in most cases, but it is believed to be triggered by infections, metabolic disturbances, inflammatory reactions, or environmental factors. Infections that may trigger PANS include Lyme disease and influenza. When the immune system fights an infection, it may mistakenly attack healthy areas of the body, including the brain, leading to the abrupt development of OCD, tics, and other symptoms associated with PANS. This phenomenon is known as molecular mimicry and results in an autoimmune response.
PANS can also be caused by metabolic disturbances, which refer to disruptions in the normal chemical processes of the body. These disruptions can affect the balance of hormones, neurotransmitters, and other vital molecules, leading to neurological and psychiatric symptoms. Additionally, PANS may be triggered by inflammatory reactions in the body. These reactions can cause an immune response that leads to inflammation in the brain, resulting in symptoms such as obsessive-compulsive behaviors, tics, anxiety, and mood changes.
Environmental factors, such as exposure to toxins or psychological stress, may also contribute to the development of PANS. These factors can influence the immune system and increase the risk of autoimmune or inflammatory responses. While the exact causes of PANS are still being investigated, researchers are working to better understand the triggers and mechanisms underlying this condition.
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PANDAS is a subset of PANS and is specifically associated with streptococcal (strep) bacteria
PANDAS, or pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, is a subset of PANS, or paediatric acute-onset neuropsychiatric syndrome. PANDAS is specifically associated with streptococcal (strep) bacteria, whereas PANS is thought to be triggered by other infections, such as Lyme disease or influenza.
PANDAS is an autoimmune condition that occurs following infection with Group A Streptococcus (strep). It is characterised by a sudden onset of symptoms, including tics and obsessive-compulsive behaviour, and is believed to be caused by the body's immune response to the strep infection. When fighting the infection, the immune system may mistakenly attack healthy areas of the body, including the brain, leading to the abrupt development of OCD, tics, and other psychiatric and neurological symptoms.
PANDAS and PANS typically first appear in children, from age 3 to puberty, and are considered rare conditions. However, it is possible, though uncommon, for teenagers and adults to develop PANDAS or PANS. The symptoms of PANDAS and PANS can last 4-6 weeks if the underlying infection is detected and treated promptly. However, symptoms can re-emerge if the patient is reinfected, and untreated infections can cause permanent psychological and neurological issues.
The best treatment for PANDAS is to address the underlying strep infection with antibiotics. Cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitor (SSRI) medication can also help manage OCD, anxiety, tics, and eating issues associated with PANDAS and PANS. While there is currently no cure for PANDAS or PANS, early treatment can reduce the duration and intensity of symptoms.
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Antibiotics can cure a current strep infection and prevent new ones
PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is a type of PANS (Paediatric Acute-onset Neuropsychiatric Syndrome). PANDAS is an autoimmune response to a strep infection, whereas PANS is thought to result from other infections such as Lyme disease or influenza.
PANDAS and PANS can cause similar symptoms, including tics, obsessive-compulsive behaviour, aggression, anxiety, depression, irritability, and difficulty with schoolwork. The symptoms usually present suddenly and intensely, and can last for 4-6 weeks. They can also re-emerge if the patient is re-infected.
While PANDAS and PANS are more prevalent in children, adults can also be diagnosed with these conditions. It is important to treat PANDAS and PANS early to reduce the duration and intensity of symptoms and prevent permanent psychological and neurological issues. Antibiotics can cure a current strep infection and prevent new ones. Antibiotics such as penicillin or amoxicillin are typically used to treat group A strep infections.
In addition to antibiotics, treatments for PANDAS and PANS include cognitive behavioural therapy (CBT) and habit reversal training. CBT can help patients better manage their mental and emotional difficulties, while habit reversal training can help decrease the frequency of symptoms such as tics.
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Adults can be diagnosed with PANDAS or PANS, although it is rare
PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is a subset of PANS (Paediatric Acute-onset Neuropsychiatric Syndrome). PANDAS is caused by an autoimmune response to a strep infection, whereas PANS is caused by other infections, such as Lyme disease or influenza. Both PANDAS and PANS are characterised by the sudden onset of symptoms, including obsessive-compulsive behaviour, tics, anxiety, depression, irritability, and mood changes. These symptoms can be intense and may come and go over time, lasting for a few days or weeks and then disappearing, only to return later.
While PANDAS and PANS typically first appear in childhood, from age 3 to puberty, it is possible, though rare, for adults to develop these conditions. Some researchers believe that it is uncommon for teenagers or adults to experience mental or neurological symptoms from strep infections. However, adults can be diagnosed with PANDAS or PANS, and neurodivergent adults may be at greater risk of developing these conditions. Autistic individuals, for example, may be more likely to develop PANS or PANDAS, and some symptoms of these conditions may overlap with neurodivergent traits, making diagnosis more difficult.
There is currently no cure for PANDAS or PANS, but treatments such as IVIG, plasmapheresis, antibiotics, and cognitive behavioural therapy can help to minimise the severity of symptoms. Early treatment is important to reduce the duration and intensity of symptoms and prevent permanent psychological and neurological issues. Antibiotics can be used to cure the underlying strep infection and prevent new infections, while also calming the autoimmune processes affecting the brain.
Diagnosis of PANDAS or PANS in adults may require a thorough evaluation by a healthcare provider, as there is no lab test to confirm these conditions. A physical exam and evaluation of symptoms will be conducted, and blood tests may be ordered if symptoms have lasted for more than a week. It is important for adults who suspect they may have PANDAS or PANS to seek medical evaluation and support.
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Frequently asked questions
Yes, adults can get PANS disease. However, it is more prevalent in children. PANS is an acronym for Pediatric Acute-onset Neuropsychiatric Syndrome.
Symptoms of PANS include compulsions, obsessions, anxiety, sensory amplification, motor abnormalities, behavioural regression, deterioration in school performance, mood disorders, urinary symptoms, and sleep disturbances.
PANS can be treated with IVIG, plasmapheresis, and antibiotics. However, there is currently no cure for PANS.
PANDAS is a subtype of PANS and is specifically associated with an infection from streptococcal (strep) bacteria. It is an acronym for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.
Although rare, adults can be diagnosed with PANDAS.
