Marianne Martinez
PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome, is a clinically defined disorder characterized by the abrupt onset of obsessive-compulsive symptoms (OCD) or eating restrictions, along with acute behavioral deterioration in at least two designated domains. PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a subset of PANS and was first reported in 1998. Both conditions are rare and can cause a range of symptoms, including anxiety, sensory amplification, motor abnormalities, behavioral regression, deterioration in school performance, mood disorders, and sleep disturbances. While the cause of PANS is often unknown, it is believed to be triggered by infections, metabolic disturbances, or inflammatory reactions. PANDAS, on the other hand, is specifically linked to streptococcal infections, with patients testing positive for recent infections such as strep throat or scarlet fever. The rtepu8zal hint people with pans refers to the potential connection between a trigger, such as an infection, and the onset of PANS or PANDAS symptoms.
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What You'll Learn
PANS and PANDAS are rare disorders
PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) are rare disorders that affect children and young adolescents. They are characterised by the sudden onset of severe obsessive-compulsive symptoms (OCD) or severely restricted food intake. PANDAS is a subset of PANS and was first reported in 1998.
PANS and PANDAS occur after an infection, most commonly a streptococcal (strep) infection. Brain inflammation occurs when the body's immune system mistakenly attacks healthy brain cells, leading to autoimmune processes that affect central nervous system function. This inflammation can cause serious debilitation and extreme neurological changes, including seizures and/or problems with balance, speech or vision. Psychiatric symptoms can also occur, including aggression, inappropriate or compulsive behaviours, or fear.
The symptoms of PANS and PANDAS usually present suddenly and intensely, and can include:
- Obsessions and compulsions
- Tics or unusual movements
- Visual or auditory hallucinations
- Sensitivity to light, sound, and touch
- Sleep disturbances or fatigue
- Anxiety
- Sensory amplification or motor abnormalities
- Behavioral regression
- Deterioration in school performance
- Mood disorder
- Urinary symptoms
PANS and PANDAS can be treated with medicines and therapy. Intravenous immunoglobulin (IVIG) therapy has been proven to help most children with PANS/PANDAS. Cognitive behavioural therapy and exposure and response prevention therapy can also help to address OCD and other behavioural and mood symptoms.
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PANS is a general term, PANDAS is specific to strep infections
PANS, or 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. It is believed to be triggered by one or more pathogens, but the specific trigger is often unknown. PANS can be treated with medicines and therapy, including cognitive behavioural therapy for OCD.
PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a subset of PANS. It is characterised by the sudden onset of OCD or disabling tics following a streptococcal (strep) infection, such as strep throat or scarlet fever. The symptoms of OCD or tic disorders can become worse following a strep infection and may include motor or vocal tics, obsessions, compulsions, mood changes, irritability, anxiety, and more. PANDAS has five distinct criteria for diagnosis, including abrupt OCD onset, an episodic symptom course, pre-pubertal onset, and the presence of neurologic and neuropsychiatric abnormalities.
While PANS is a general term for the clinically defined disorder, PANDAS specifically refers to cases where the onset of OCD or disabling tics is associated with streptococcal infections. PANDAS is a subcategory of PANS, and the two conditions share many similar symptoms, including OCD, tics, mood swings, irritability, aggression, behavioural regression, deterioration in school performance, sensory abnormalities, and sleep disturbances. However, the key distinction between the two is the presence of a strep infection trigger in PANDAS.
Both PANS and PANDAS are rare disorders that can cause extreme neurological changes and psychiatric symptoms. They are not contagious, and treatment typically involves a combination of medications and therapy. While there is no specific test to diagnose PANDAS, a test for strep bacteria or a history of the bacteria is necessary to confirm the diagnosis. In contrast, PANS may be diagnosed through blood tests or brain scans to identify potential infection triggers other than strep.
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PANS and PANDAS are triggered by infections
PANS and PANDAS are rare disorders that are often mistaken for other conditions. PANS stands for "Pediatric Acute-onset Neuropsychiatric Syndrome", while PANDAS stands for "Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections". Both conditions are believed to be triggered by infections, with PANDAS specifically associated with streptococcal infections.
PANS and PANDAS are thought to be triggered by the body's immune response to an infection. In the case of PANDAS, it is believed that the child's immune system produces antibodies to fight the bacteria that caused a streptococcal infection. However, these antibodies may also mistakenly attack healthy cells in other tissues, including the brain, leading to psychological and neurological symptoms. These symptoms can include obsessive-compulsive disorder (OCD), tics, anxiety, personality changes, and more. PANDAS is typically triggered by strep throat infections, but it has also been associated with perianal strep infections and other sites such as the nasal cavity.
PANS, on the other hand, is believed to be triggered by a wider range of infections, including Lyme disease, influenza, varicella, and mycoplasma pneumoniae. Like PANDAS, PANS can also cause OCD symptoms, but it is not limited to streptococcal infections. PANS is characterised by the sudden onset of OCD or eating restrictions, along with acute behavioural deterioration in at least two designated domains. Other symptoms may include anxiety, sensory amplification, motor abnormalities, behavioural regression, and more.
The symptoms of PANS and PANDAS can vary from patient to patient but generally present suddenly and intensely. They can also be episodic, with symptoms getting better and then worsening again. PANS and PANDAS can be treated with medications and therapy, and early intervention is recommended. While there is no specific test for PANDAS, a clinical diagnosis can be made by a doctor based on testing for active infections, evaluating symptoms, medical history, and laboratory findings.
In summary, PANS and PANDAS are believed to be triggered by infections, with PANDAS specifically associated with streptococcal infections. Both conditions involve the immune system mistakenly attacking healthy brain cells, leading to a range of psychological and neurological symptoms. Early diagnosis and treatment are important to help manage the symptoms and provide support to affected individuals and their families.
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PANS and PANDAS cause severe OCD symptoms
PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) are two names for a mental health condition known as acute-onset OCD (obsessive-compulsive disorder). PANS and PANDAS cause a sudden onset of severe OCD symptoms. They also cause other sudden and extreme changes in a child's behaviour, thoughts, feelings, and movement.
PANS and PANDAS are believed to be triggered by an infection, most commonly a strep infection. When the infection is clearly linked to strep, it is called PANDAS. When it is linked to another infection, such as Lyme disease, chickenpox, mycoplasma, or the flu, it is called PANS. In rare cases, PANDAS has also been associated with perianal strep infections.
The severe OCD symptoms of PANS and PANDAS can include new and intense fears, concerns, and stressful thoughts or images that are difficult to manage and can be so strong that a child may be hard to comfort. Compulsions or rituals may also develop, such as repeatedly washing hands or touching things, or repeating actions like walking in and out of a doorway until it feels "right".
The onset of PANS and PANDAS can vary from patient to patient, but the symptoms usually present suddenly and intensely. Symptoms can also get better and then worse again in an episodic manner.
While the exact cause of PANS and PANDAS is still being researched, they are believed to be related to a problem with the immune system's response to an infection. Instead of attacking the germs, the immune system mistakenly targets the basal ganglia, a part of the brain that affects thoughts, feelings, movement, and behaviour. This irritation in the basal ganglia is thought to lead to the symptoms of PANS and PANDAS.
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Treatments include medicine and therapy
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 confusing and distressing symptoms. PANS and PANDAS can be treated with medicines and therapy.
PANS 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. Comorbid PANS symptoms may include anxiety, sensory amplification or motor abnormalities, behavioural regression, deterioration in school performance, mood disorders, urinary symptoms, and/or sleep disturbances. PANS does not require a known trigger, although it is believed to be triggered by one or more pathogens.
PANDAS, a subset of PANS, was first reported in 1998 and has five distinct criteria for diagnosis, including abrupt "overnight" OCD or dramatic, disabling tics; a relapsing-remitting, episodic symptom course; and young age at onset. PANDAS is specifically diagnosed when the triggering infection is strep.
Treatments for PANS and PANDAS include medicine and therapy. Treatment starts with medicine to take care of the infection. Doctors and mental health experts can also give families guidance and support to help them through challenging times. Treatment also includes cognitive behavioural therapy for OCD, conducted by a trained mental health provider. Therapy for OCD includes exposure and response prevention, which reduces ritual behaviours. Therapy can also address other behaviour and mood symptoms that may be part of PANS or PANDAS. For example, a therapy called habit reversal can help if a child has tics.
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