Emilie Meyer
PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome, is a rare disorder that is often mistaken for other conditions. It is characterised by a dramatic, almost overnight onset of neuropsychiatric symptoms, including obsessive-compulsive disorder (OCD) and/or an eating disorder. PANS is believed to be triggered by a variety of infections, metabolic disturbances, and other inflammatory reactions. The exact prevalence of PANS is unknown, but it is estimated to affect around 1 in 200 children, with considerable variation across different geographical locations. PANS is often overlooked by medical professionals due to the assumption that there is no underlying medical cause for the psychiatric symptoms presented by patients. However, PANS can cause serious debilitation and extreme neurological changes, and successful treatment requires an integrative medicine approach addressing various factors such as diet, gut health, and latent infections.
| Characteristics | Values |
|---|---|
| Prevalence | A retrospective study showed that the estimated annual incidence of PANS was 1 in 11,765 children between 3 and 12 years of age. However, the true lifetime prevalence of PANS is not known. The PANS Network estimates that it affects as many as 1 in 200 children, but most doctors believe it is a rare disorder. |
| Symptoms | Sudden and severe onset of symptoms, including obsessive-compulsive disorder (OCD), eating disorders, tics, anxiety, irritability, uncontrolled emotions, depression, aggression, oppositional behavior, behavioral regression, and deterioration in school performance. |
| Causes | PANS is caused by a combination of genetic predisposition and environmental stressors, often an infection. However, the specific trigger is unknown in most cases. |
| Treatment | There is no definitive cure for PANS, but successful treatment involves addressing the underlying infection, reducing inflammation, and an integrative medicine approach focusing on diet, gut health, latent infections, and toxic load. Intravenous immunoglobulin (IVIG) therapy, plasmapheresis, steroids, and cognitive behavioral therapy are also used. |
| Diagnosis | PANS is diagnosed based on sudden onset of OCD or restricted food intake, along with two of the following: emotional lability, irritability, aggression, oppositional behavior, behavioral regression, and deterioration in school performance. |
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What You'll Learn
PANS is rare, but underdiagnosis is possible
PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) is a rare disorder, but its underdiagnosis is possible. PANS is an umbrella classification for a syndrome that can be caused by almost any infection. It is characterised by a dramatic, almost overnight onset of neuropsychiatric symptoms, including obsessive-compulsive disorder (OCD) or eating disorders, anxiety, irritability, uncontrolled emotions, and/or depression. The cause of PANS is unknown in most cases, but it is believed to be triggered by infections, metabolic disturbances, and other inflammatory reactions.
The rarity of PANS could be due to underdiagnosis or the lack of awareness among physicians about the disorder. The symptoms of PANS are often mistaken for other conditions, and doctors may not associate them with PANS. For instance, physicians may not inquire about specific symptoms or fail to elicit a thorough history, making it challenging to identify the abrupt onset of symptoms characteristic of PANS.
The estimated annual incidence of PANS varies across different studies and populations. One study reported that PANS affects 1 in 11,765 children between 3 and 12 years of age, while another source estimates it to be as common as 1 in 200 children. However, it is important to note that there hasn't been a large population study on the incidence of PANS, so the exact prevalence is unknown.
The increase in PANS cases could be attributed to several factors. Firstly, PANS is a rare disorder, and its symptoms can vary significantly across geography and time, making it challenging to diagnose. Secondly, PANS may be underdiagnosed due to a lack of awareness among physicians about the disorder and its diagnostic criteria. Additionally, the symptoms of PANS can be similar to those of other conditions, leading to potential misdiagnosis.
To conclude, while PANS is considered a rare disorder, the possibility of underdiagnosis exists due to various factors, including the lack of awareness among medical professionals and the heterogeneous nature of the disorder. Further research and large-scale population studies are needed to better understand the true prevalence of PANS and improve its diagnosis and management.
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PANS is a clinical diagnosis
PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome, is an umbrella classification for a syndrome that can be caused by almost any infection. PANS is a clinical diagnosis given to children who have a sudden onset of neuropsychiatric symptoms, including obsessive-compulsive disorder (OCD) and/or an eating disorder. The symptoms of PANS can appear in as little as a few days after the initial infection or as long as 4 to 6 months if antibiotics did not fully eradicate the bacteria.
The exact prevalence of PANS is unknown, but it is considered a rare disorder. A retrospective study conducted in three geographically and demographically diverse sections of the US found that the estimated annual incidence of PANS was 1 in 11,765 children between 3 and 12 years of age, with considerable variation across locations. Another source estimates that PANS affects 1 in 200 children, although most doctors still believe the condition is rare.
PANS is often overlooked by medical doctors because of the assumption that there is no underlying medical cause for the patient's psychiatric symptoms. Additionally, there is a lack of awareness about PANS among physicians, leading to potential underdiagnosis. The diagnosis of PANS is based on evaluating the signs, symptoms, medical history, and laboratory findings that rule out other known neurological or medical disorders. Blood tests conducted on children with PANS may show signs of inflammation.
The symptoms of PANS include sudden onset of OCD or severely restricted food intake, along with at least two of the following: emotional lability (mood swings), depression, irritability, aggression, oppositional behavior, behavioral regression, and sudden deterioration in school performance. These symptoms can have a significant impact on the healthy outcome of a child's life, affecting their academic performance and overall well-being.
While there is currently no definitive cure for PANS, successful treatment requires an integrative medicine approach addressing diet, gut health, latent infections, toxic load, and more. Treatment typically involves a combination of antibiotics to treat any underlying infections, anti-inflammatories, and, in some cases, immunosuppressive medications to calm the immune response.
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PANS symptoms can appear suddenly
PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome, is characterised by its acute onset, with symptoms reaching full intensity within 48 hours. PANS symptoms can indeed appear suddenly, and parents can often identify the day when their child's symptoms began.
The symptoms of PANS can be separated into three severity levels: mild, moderate, and severe. A typical patient will develop symptoms within a week, with an abrupt and acute onset over 24-48 hours. Symptoms may then reach maximum intensity over a longer time frame. The onset of symptoms can be assigned to a particular day, and the symptoms may continue to appear and grow in intensity over the next few days or weeks.
The symptoms of PANS include anxiety, emotional lability and/or depression, irritability, aggression, severe oppositional behaviours, behavioural (developmental) regression, sudden deterioration in school performance, motor or sensory abnormalities, and somatic signs and symptoms. These symptoms are not better explained by a known neurological or medical disorder.
PANS is thought to be triggered by an environmental stressor, often an infection. The most common diseases are strep, influenza, Lyme disease, and mycoplasma pneumonia. In some children and adolescents, these infections can trigger an autoimmune response. However, the trigger for PANS is not always known.
PANS is a rare disorder with substantial heterogeneity across geography and time. It is often overlooked by medical doctors because of the assumption that there is no underlying medical cause for the patient's psychiatric symptoms.
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PANS is caused by an unknown trigger
PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome, is an umbrella classification for a syndrome that can be caused by almost any infection. PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection, is a subset of PANS. The trigger for PANDAS is known to be a Streptococcal infection, specifically the streptococcal bacteria associated with strep throat. However, the trigger for PANS is unknown.
PANS and PANDAS are believed to be caused by the immune system attacking cells in the basal ganglia, the part of the brain responsible for motor skills, learning, and behavior. This results in severe neuropsychiatric symptoms, including obsessive-compulsive disorder (OCD), severely restricted food intake, tics, anxiety, irritability, uncontrolled emotions, depression, and poor academic performance.
The exact prevalence of PANS is unknown, but it is considered a rare disorder. A retrospective study in the United States estimated an annual incidence of 1 in 11,765 children between 3 and 12 years of age, with geographical variation. Another estimate suggests that PANS affects 1 in 200 children, although most doctors still believe it is rare.
The diagnosis of PANS and PANDAS can be challenging, and these conditions are often overlooked by medical doctors due to the assumption that there is no underlying medical cause for the psychiatric symptoms. However, it is important to identify and treat any underlying infections and reduce inflammation to improve symptoms. Treatment options include antibiotics, anti-inflammatories, and in some cases, immunosuppressive medications.
While the exact trigger for PANS remains unknown, it is believed to be caused by an environmental stressor, often an infection. Further research is needed to better understand the prevalence, causes, and treatment options for PANS.
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PANS and PANDAS are often overlooked by doctors
PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection) are often overlooked by doctors due to several reasons, primarily the assumption that psychiatric symptoms do not have an underlying medical cause. This assumption, coupled with the rarity of the disorders and the lack of awareness among physicians, contributes to PANS and PANDAS being underdiagnosed or misdiagnosed.
PANS and PANDAS are rare disorders with substantial geographical and temporal variation. The estimated annual incidence of PANDAS/PANS in one study was 1 in 11,765 children between 3 and 12 years of age, with 46% of cases related to GAS (Group A Streptococcus). However, the true lifetime prevalence is unknown. The PANS Network estimates that PANS/PANDAS affects as many as 1 in 200 children, although most doctors still consider it a rare condition.
The lack of awareness among physicians about PANS and PANDAS leads to symptoms being overlooked or misinterpreted. Common symptoms such as anxiety, food restriction, eating disorders, obsessive-compulsive disorder (OCD), and tic disorders may be present, but doctors may not associate them with PANS or PANDAS. The abrupt onset of symptoms, including neuropsychiatric conditions, anxiety, irritability, uncontrolled emotions, and academic deterioration, can occur within 2 to 3 days and reach full intensity within 24 to 48 hours. However, without knowledge of these disorders, physicians may fail to identify the characteristic sudden onset and instead attribute the symptoms to other causes.
Additionally, PANS and PANDAS are often mistaken for other conditions due to their overlapping symptoms. PANDAS, for example, is associated with streptococcal infections, similar to strep throat, and can exhibit similar symptoms. The assumption that psychiatric symptoms do not have a medical cause further complicates the diagnostic process, as doctors may attribute the symptoms to purely psychological or behavioural issues rather than considering an underlying biological basis.
The lack of large-scale population studies on the incidence of PANS and PANDAS also contributes to the challenges in recognising and diagnosing these disorders. While there is growing awareness among the medical community about the effects of neuroinflammatory immune disorders like PANS and PANDAS, more research is needed to fully understand their prevalence, causes, and treatment options.
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Frequently asked questions
PANS is a rare disorder, but its prevalence is difficult to determine as it is often mistaken for other conditions. A retrospective study in the US estimated an annual incidence of 1 in 11,765 children between 3 and 12 years of age, while other sources estimate 1 in 200 children.
PANS is characterised by a dramatic and rapid onset of neuropsychiatric symptoms, including obsessive-compulsive disorder (OCD), eating disorders, mood swings, irritability, anxiety, and poor academic performance.
The exact cause of PANS is unknown, but it is believed to be triggered by infections, metabolic disturbances, and other inflammatory reactions. It is thought that children who develop PANS have a genetic predisposition that is triggered by an environmental factor, often an infection.
There is currently no definitive cure for PANS, but successful treatment involves an integrative medicine approach addressing diet, gut health, latent infections, and toxic load. Treatment options include antibiotics, anti-inflammatories, and therapies to quiet the immune response.
PANS is diagnosed based on the sudden onset of OCD or severely restricted food intake, along with two of the following seven criteria: emotional lability, irritability, aggression, oppositional behaviour, behavioural regression, and sudden deterioration in school performance.
