Tiffany Haney
Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) are severe forms of obsessive-compulsive disorder (OCD) that appear suddenly in young children, accompanied by other distressing symptoms. PANS and PANDAS are episodic disorders, meaning that symptoms may disappear for extended periods and then reappear. PANDAS is a subtype of PANS and is specifically associated with a streptococcal (strep) bacterial infection. While PANS may be triggered by various infections, immune system issues, or environmental factors. The symptoms of both conditions are usually intense, occur quickly, and may worsen with multiple recurrences.
| Characteristics | Values |
|---|---|
| Symptoms | Severe OCD, restricted eating, anger, depression, anxiety, panic attacks, tics, irritability, loss of academic ability, uncontrollable emotions, noticeable changes in mood, behaviour, sensory and motor function |
| Onset | Sudden, severe, intense, within 24 to 48 hours, dramatic, seemingly inexplicable |
| Treatment | Cognitive behavioural therapy, selective serotonin reuptake inhibitor (SSRI) medication, antibiotics, habit reversal training |
| Cause | Unknown, possibly triggered by infections, metabolic disturbances, inflammatory reactions, immune system issues, environmental factors |
| Risk Factors | Frequent group A streptococcal infections, family history of autoimmune diseases or rheumatic fever |
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What You'll Learn
PANS and PANDAS are rare
PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) are rare conditions that usually affect children before puberty. They are characterised by a sudden and severe onset of obsessive-compulsive disorder (OCD) or restrictive eating disorders. PANDAS is a subtype of PANS and is specifically associated with an infection from streptococcal (strep) bacteria, such as strep throat or scarlet fever.
PANS and PANDAS are episodic disorders, meaning that symptoms may disappear for extended periods and then reappear. For example, if a child with PANDAS gets another strep infection, their symptoms may worsen. Symptoms may get increasingly severe with multiple recurrences. PANS and PANDAS are often associated with noticeable changes in mood, behaviour, and sensory and motor function in children.
The exact causes of PANS are unknown, but one theory is that it is triggered by an immune response that leads to inflammation in the brain. Infections other than strep, immune system disruptions, or environmental factors may cause this reaction. When the immune system mistakenly attacks healthy brain tissue, it can lead to sudden and severe symptoms, such as obsessive-compulsive behaviours, tics, anxiety, and mood changes.
PANDAS, on the other hand, is believed to be caused by a strep infection. When the immune system fights the infection, it may mistakenly attack healthy areas of the body, including the brain, which can lead to the sudden development of OCD, tics, and other symptoms. While the exact prevalence of PANS and PANDAS is unknown, these conditions are considered rare.
There are various treatments available for PANS and PANDAS. For PANDAS, the best treatment for sudden episodes is to treat the underlying strep infection with antibiotics. Cognitive behavioural therapy and selective serotonin reuptake inhibitor (SSRI) medication may also be beneficial in managing OCD, anxiety, tics, or eating issues associated with both PANS and PANDAS. Intravenous immunoglobulin (IVIG) therapy has also been proven to help the majority of children with PANDAS/PANS, although health insurance claims are often denied.
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PANS and PANDAS are episodic disorders
The symptoms of PANS and PANDAS are usually intense, occur quickly and unexpectedly, and may come and go over time. They are often diagnosed with obsessive-compulsive disorder (OCD) or an eating disorder, but the sudden onset of symptoms separates them from these other disorders. Children with PANS or PANDAS may have symptoms such as anxiety, tics, mood changes, anger, depression, uncontrollable emotions, irritability, and loss of academic ability and handwriting skills. The symptoms are thought to be caused by an immune response that leads to inflammation in the brain. When the immune system fights an infection, it may mistakenly attack healthy areas of the brain, leading to the sudden development of OCD, tics, and other symptoms.
The causes of PANS are unclear and varied, and healthcare providers must rule out many other conditions before diagnosing PANS or PANDAS. Diagnosing PANS or PANDAS can be challenging because infections, anxiety, and tic disorders are common in children, and no lab tests can confirm PANS or PANDAS. Instead, diagnosis often requires a thorough evaluation. The outlook for PANS or PANDAS varies depending on the severity of symptoms, the underlying cause, and how quickly treatment is sought.
Treatment for PANS or PANDAS typically involves a combination of medicines and therapy. Cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitor (SSRI) medication have been shown to be effective in reducing symptoms. In addition, children with PANDAS may be treated with antibiotics to address the underlying strep infection. It is important to work closely with a healthcare provider to manage PANS or PANDAS and make any necessary treatment adjustments.
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PANS and PANDAS are characterised by a sudden onset of OCD
PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) are characterised by a sudden and severe onset of obsessive-compulsive disorder (OCD) symptoms in children. PANDAS is a subtype of PANS and is specifically associated with a streptococcal strep bacterial infection, such as strep throat or scarlet fever. PANS may be triggered by various other infections, such as the flu, chickenpox, mycoplasma, and Lyme disease, as well as immune system issues or environmental factors.
The symptoms of PANS and PANDAS can be so extreme that parents may describe their child as having "changed overnight". The onset of OCD symptoms is accompanied by other disturbing and distressing symptoms, including noticeable changes in mood, behaviour, sensory function, and motor function. Children with PANS or PANDAS may experience irritability, sadness, or a tendency to laugh or cry unexpectedly and inappropriately. They may also exhibit compulsive behaviours, such as constant handwashing or ritualistic behaviours, and experience intense fears or concerns about things being even, clean, or dirty. These fears and concerns can be so strong that the child may be difficult to comfort.
The exact causes of PANS are not yet fully understood, and researchers are still working to identify the specific antibody that may cause PANDAS. However, one theory suggests that PANS is triggered by an immune response that leads to inflammation in the brain. This immune response may be caused by infections other than strep, immune system disruptions, or environmental factors. In the case of PANDAS, it is believed that when the immune system fights the strep infection, it may mistakenly attack healthy areas of the brain, leading to the sudden development of OCD symptoms.
Diagnosing PANS or PANDAS can be challenging due to the lack of well-accepted evidence and specific lab tests for confirmation. Health care providers must rule out other conditions and perform a thorough evaluation, taking into account the child's symptoms, medical history, and potential infections. Treatment for PANS or PANDAS focuses on addressing the underlying cause, managing symptoms, and supporting the immune system. This may include antibiotics to treat infections, cognitive behavioural therapy, selective serotonin reuptake inhibitor (SSRI) medication, or a combination of these approaches.
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PANDAS is a specific type of PANS
PANS and PANDAS are severe forms of obsessive-compulsive disorder (OCD) that appear suddenly in young children, accompanied by other confusing and distressing symptoms. PANS (Paediatric Acute-onset Neuropsychiatric Syndrome) is a more general term that does not specify the type of infection thought to trigger the symptoms. It is called "acute onset" because the behaviour changes come on suddenly, reaching full-scale intensity within 24 to 48 hours. PANS may be triggered by various infections, immune system issues, or environmental factors.
PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is a subtype of PANS and is specifically associated with an infection from streptococcal (strep) bacteria, such as strep throat or scarlet fever. PANDAS is an autoimmune condition that occurs following an infection with Group A Streptococcus (strep). This disease is categorized as Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). Therefore, PANDAS is a type of PANS. In other words, PANDAS without strep is PANS.
PANDAS and PANS are episodic disorders, meaning that symptoms may disappear for extended periods and then reappear. For example, if a child with PANDAS gets another strep infection, their symptoms may worsen. Symptoms may get increasingly severe with multiple recurrences. The best treatment for sudden episodes of PANDAS is to treat the strep infection with antibiotics. Health care providers will order a throat culture to see if strep bacteria are present. If the throat culture is positive, antibiotics are usually prescribed to treat the infection and reduce PANDAS symptoms.
PANS and PANDAS are severe forms of OCD that appear suddenly in young children, accompanied by other confusing and distressing symptoms. PANDAS is a more specific term used when the triggering infection is strep. Children with PANS or PANDAS may benefit from cognitive behavioural therapy, selective serotonin reuptake inhibitor (SSRI) medication, or both to help manage OCD, anxiety, tics, or eating issues.
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Treatment options for PANS and PANDAS
PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) are severe forms of obsessive-compulsive disorder (OCD) that appear suddenly in young children, accompanied by other distressing symptoms. PANDAS is a subtype of PANS and is specifically associated with a streptococcal infection, such as strep throat or scarlet fever.
Treatment for PANS and PANDAS focuses on addressing the underlying cause, managing symptoms, and supporting the immune system. Antibiotics are often used to treat strep infections and reduce PANDAS symptoms. Beta-lactams, including penicillin and amoxicillin, are the most effective antibiotics for Group A Streptococcal (GAS) infections. Antibiotics can also help control or reduce symptoms of PANDAS, such as OCD, anxiety, depression, and tics. However, there is insufficient evidence to recommend their long-term use.
Intravenous administration of immunoglobulins (IVIG) and similar treatments may improve PANS and PANDAS symptoms by addressing the underlying infection and autoimmune reaction. However, these treatments can cause side effects, including nausea, vomiting, headaches, dizziness, and infection. Plasmapheresis is another invasive procedure with risks that has shown to improve symptoms, but few healthcare providers offer it.
Non-invasive treatment options include over-the-counter anti-inflammatory drugs, such as oral nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, which can help control the inflammation caused by the autoimmune response. Cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitor (SSRI) medication can also help manage OCD, anxiety, tics, or eating issues associated with PANS and PANDAS.
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Frequently asked questions
Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) are conditions that cause a sudden and severe onset of obsessive-compulsive disorder (OCD) or restrictive eating disorder in children before puberty. PANDAS is a subtype of PANS and is specifically associated with a streptococcal (strep) bacterial infection.
Symptoms of PANS and PANDAS include sudden and severe obsessions, compulsions, or both. Children with PANS or PANDAS may also experience noticeable changes in mood, behaviour, sensory and motor function, anxiety, depression, irritability, anger, and difficulty with schoolwork.
PANS and PANDAS are episodic disorders, meaning that symptoms may disappear for extended periods and then reappear. Symptoms may get increasingly severe with multiple recurrences. However, there is a lack of compelling evidence to support the efficacy of treatments for PANS, and the exact causes of PANS are unknown.
