Marianne Martinez
PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) are increasingly recognised as forms of autoimmune encephalitis. While PANDAS is a subset of PANS, the two conditions are not officially recognised by the Centers for Disease Control and Prevention (CDC) as childhood diseases. However, many of the underlying symptoms of PANDAS or PANS, such as anxiety, OCD, and Tourette Syndrome, are recognised as child development-specific conditions.
| Characteristics | Values |
|---|---|
| CDC Recognition | The CDC does not recognize PANS or PANDAS as childhood diseases or disabilities. |
| Underlying Symptoms Recognized by CDC | The CDC recognizes underlying symptoms as "child development-specific conditions", including anxiety, OCD, and Tourette Syndrome. |
| PANS/PANDAS Recognition | PANS/PANDAS is increasingly recognized as a form of autoimmune encephalitis (AE) or post-infectious basal ganglia encephalitis (BGE). |
| PANS Definition | Pediatric Acute-Onset Neuropsychiatric Syndrome. |
| PANDAS Definition | Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. |
| PANS/PANDAS Causes | An immune system problem where the body mistakenly attacks healthy brain cells, leading to inflammation and autoimmune processes affecting the central nervous system. |
| PANS/PANDAS Symptoms | Abrupt onset of OCD, tics, restricted eating, irritability, aggressive behavior, mood changes, deterioration of motor skills, unusual movements, hallucinations, sensory sensitivities, sleep disturbances, and fatigue. |
| PANS/PANDAS Diagnosis | There are no lab tests for PANS/PANDAS; diagnosis is based on clinical features, patient history, and disease trajectory, symptoms, and severity. |
| PANS/PANDAS Treatment | Treatment includes medicines, cognitive behavioral therapy, and family guidance and support. |
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What You'll Learn
PANDAS and PANS are not recognised as childhood diseases by the CDC
PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) are not recognised as childhood diseases by the CDC (Centers for Disease Control and Prevention). However, many of the underlying symptoms of PANDAS or PANS are recognised as "child development-specific conditions", such as anxiety, OCD, and Tourette Syndrome.
PANDAS is a subset of PANS and was first reported by a team at the National Institute of Mental Health in 1998. PANDAS is considered a paediatric disorder and typically first appears in childhood from age 3 to puberty. Reactions to strep infections are rare after age 12, but researchers recognise that PANDAS could occur, though rarely, among adolescents. It is unlikely that someone would experience these post-strep neuropsychiatric symptoms for the first time as an adult, but it has not been fully studied.
PANS is a broad-spectrum syndrome that can result from a variety of disease mechanisms and multiple etiologies. PANS does not require a known trigger, although it is believed to be triggered by one or more pathogens. PANS has been reported to occur in association with a variety of infectious agents, including influenza, varicella, and mycoplasma pneumoniae.
The symptoms of PANDAS and PANS can be so extreme that a parent may say their child seemed to "change overnight". Children with PANDAS and PANS will have sudden and severe obsessions, compulsions, or both. They can also experience symptoms of ADHD, such as hyperactivity, inattention, or fidgeting, and separation anxiety.
PANDAS and PANS can be treated with medicines and therapy. Doctors and mental health experts can also give families guidance and support to help them through challenging times.
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PANDAS is a subset of PANS
PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. It is a subset of PANS and was first reported by a team at the National Institute of Mental Health (NIMH) in 1998. PANDAS is considered a paediatric disorder that typically appears in childhood, from age 3 to puberty, and rarely in adolescence. It is characterised by the sudden onset of OCD, tics, and other neuropsychiatric symptoms.
PANS can be triggered by various infectious agents, including streptococcus pyogenes, influenza, and mycoplasma pneumoniae, as well as non-infectious agents such as environmental factors. PANDAS, on the other hand, specifically requires that symptoms be associated with a strep infection. While strep throat is a common trigger, PANDAS has also been associated with perianal strep infections.
The diagnosis of PANDAS is based on five criteria, including abrupt "overnight" OCD or dramatic, disabling tics, a relapsing-remitting episodic course, and young age at onset. PANS diagnosis does not require a known trigger, but it often follows exposure to infectious or non-infectious agents. The PANDAS Physicians Network (PPN) provides flowcharts to help clinicians evaluate patients and determine the appropriate treatment protocols for PANS and PANDAS.
While the Centers for Disease Control and Prevention (CDC) does not categorise PANDAS or PANS as a disability, many of the underlying symptoms are recognised as "child development-specific conditions", such as anxiety, OCD, and Tourette Syndrome.
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PANDAS is caused by a streptococcal infection
PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a rare but severe disorder that occurs after a streptococcal infection. It is considered an autoimmune disease based on a streptococcal infection with a verified immune response. The onset of symptoms is often dramatic, with obsessive-compulsive disorder (OCD) symptoms developing within 24-48 hours.
Once the body recognizes these molecules as foreign, the child's immune system reacts by producing antibodies. This is known as molecular mimicry, and it causes the immune system to react not only to the strep molecules but also to the human host molecules that were mimicked. As a result, antibodies "attack" the mimicked molecules in the child's own tissues, including those in the brain. This leads to the onset of neuropsychiatric symptoms such as OCD, tics, and other abnormal movements, personality changes, and more.
The symptoms of PANDAS usually present suddenly and intensely, and they can vary from patient to patient. In addition to OCD and tics, children with PANDAS may experience mood changes such as irritability or aggressive behaviour, extreme moodiness or depression, deterioration of motor skills, visual or auditory hallucinations, sensitivity to light, sound, and touch, sleep disturbances or fatigue, and more. PANDAS can also cause restrictive eating habits, which can result in dramatic weight loss.
While PANDAS is not officially recognized by the Centers for Disease Control and Prevention or other U.S. regulatory health agencies as a childhood disease, many of the underlying symptoms are recognized as "child development-specific conditions". These include anxiety, OCD, and Tourette Syndrome.
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PANS can be triggered by pathogens
The Centers for Disease Control and Prevention (CDC) does not recognize PANS or PANDAS as childhood diseases. However, many of the underlying symptoms of PANS or PANDAS are recognized as "child development-specific conditions," such as anxiety, OCD, and Tourette Syndrome.
PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) are believed to be triggered by pathogens, toxins, and infections. PANS is a broad-spectrum syndrome that can result from a variety of disease mechanisms and multiple etiologies. While strep throat infections are the most common trigger, PANDAS has been associated with perianal strep infections as well. PANDAS is considered a subset of PANS and was first reported by a team at the National Institute of Mental Health in 1998.
PANDAS, on the other hand, is specifically triggered by streptococcal infections. The strep bacteria are ancient organisms that survive by hiding from the immune system as long as possible. They do this by putting molecules on their cell walls so that they look nearly identical to molecules found in the child's heart, joints, skin, and brain. The immune system then attacks not only the strep molecules but also the human host molecules that were mimicked. This results in OCD, tics, and other neuropsychiatric symptoms.
PANS and PANDAS are often treated with three complementary modes of intervention, depending on disease trajectory, symptoms, severity, lab work, and patient history.
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PANDAS and PANS can be treated with medicine and therapy
PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a condition in which a child experiences a sudden onset of severe OCD symptoms and other behavioural changes. These can include tics, anxiety, mood changes, and more. PANS, or Pediatric Acute-Onset Neuropsychiatric Syndrome, is similar but is triggered by an infection other than streptococcal, such as the flu, chickenpox, mycoplasma, or Lyme disease.
While the U.S. Centers for Disease Control and Prevention do not recognize PANDAS or PANS as childhood diseases, many of the underlying symptoms are recognized as "child development-specific conditions". These include anxiety, OCD, and Tourette Syndrome.
In addition to these treatments, there are other interventions that can be used to manage PANDAS and PANS. These include tonsillectomy, NSAIDs, and psychotropics. However, more research is needed to determine the most effective treatment strategies for these disorders.
It is important to work closely with a doctor or therapist to determine the best course of treatment for PANDAS or PANS. Early diagnosis and treatment are crucial to managing the symptoms and improving the child's quality of life.
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Frequently asked questions
PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, a subset of PANS. PANS stands for Pediatric Acute-Onset Neuropsychiatric Syndrome. Both conditions cause a sudden onset of severe OCD symptoms and other sudden changes in a child's behaviour.
The Centers for Disease Control and Prevention do not categorize PANDAS or PANS as a disability. In fact, U.S. regulatory health agencies have not officially recognized PANDAS or PANS as childhood diseases. However, many of the underlying symptoms of PANS/PANDAS are recognized as "child development-specific conditions", such as anxiety, OCD, and Tourette Syndrome.
PANS/PANDAS can be treated with medicines and therapy. Doctors and mental health experts can also give families guidance and support to help them through challenging times.
