Emilie Meyer
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. PANS is believed to be triggered by infections, metabolic disturbances, or other inflammatory reactions. The exact prevalence of PANS is unknown, but estimates suggest it affects approximately 1 in 200 children. PANS is often misdiagnosed or overlooked by medical professionals, leading to underreporting and inaccurate prevalence estimates.
| Characteristics | Values |
|---|---|
| Prevalence | Affects approximately 1 in 200 children |
| Cause | Triggered by one or more pathogens, including streptococcal (strep) bacteria |
| Symptoms | Obsessive-compulsive behaviours (OCD), anxiety, tics, mood swings, depression, irritability, aggression, oppositional behaviour, behavioural regression, deterioration in school performance, sensory amplification, motor abnormalities, urinary symptoms, sleep disturbances, eating restrictions |
| Diagnosis | Clinical diagnosis by a doctor based on testing for active infections, evaluating symptoms, medical history, and laboratory findings |
| Treatment | Medicines and therapy, including cognitive behavioural therapy for OCD |
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What You'll Learn
PANS is rare, affecting around 1 in 200 children
PANS, or Pediatric Acute-Onset Neuropsychiatric Syndrome, is a rare disorder that affects around 1 in 200 children. It is characterised by the sudden onset of obsessive-compulsive symptoms (OCD) or eating restrictions, along with acute behavioural deterioration in at least two designated domains. PANS is often mistaken for other conditions, and its precise prevalence is not completely clear. However, estimates suggest it affects approximately 1 in 200 children.
PANS is a clinically defined disorder with symptoms that can include anxiety, sensory amplification, motor abnormalities, behavioural regression, deterioration in school performance, mood disorders, urinary symptoms, and sleep disturbances. The cause of PANS is unknown in most cases but is thought to be triggered by infections, metabolic disturbances, and other inflammatory reactions. It is believed to be caused by a problem with the immune system's response to an infection, where instead of attacking the germs, the immune system targets the basal ganglia part of the brain by mistake. This can lead to symptoms such as OCD, tics, anxiety, and mood changes.
PANS is diagnosed by a healthcare provider using specific criteria, including the sudden onset of OCD or severely restricted food intake, along with the sudden onset of at least two other neuropsychiatric symptoms. A history of a strep infection within three months of symptom onset and physical hyperactivity or unusual movements outside the child's control are also considered. If symptoms have lasted over a week, blood tests may be ordered to check for a recent strep infection.
PANS can be treated with medicines and therapy, and early intervention is essential. Doctors and mental health experts can provide guidance and support to help families through challenging times. Treatment includes cognitive behavioural therapy for OCD, exposure and response prevention to reduce ritual behaviours, and other therapies to address behaviour and mood symptoms.
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PANS is often misdiagnosed or overlooked
PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) is often misdiagnosed or overlooked by medical professionals due to several reasons. Firstly, it is a rare and lesser-known disorder, and doctors often mistake it for other conditions. The exact prevalence of PANS is unknown, but it is considered rare, and estimates suggest it affects approximately 1 in 200 children. This lack of clarity on the true prevalence contributes to underreporting and underrecognition of the condition.
Secondly, PANS shares symptoms with other disorders, which can lead to misdiagnosis. It is characterized by the sudden onset of obsessive-compulsive symptoms (OCS) or eating restrictions, along with acute behavioural deterioration in at least two designated domains. These can include anxiety, sensory amplification, motor abnormalities, behavioural regression, deterioration in school performance, mood disorders, urinary symptoms, and sleep disturbances. The sudden onset of symptoms helps distinguish PANS from other disorders such as OCD or eating disorders.
Thirdly, PANS is often misdiagnosed or overlooked due to the complexity of the diagnostic process. A clinical diagnosis of PANS is made by a doctor based on testing for active infections, evaluating symptoms, medical history, and laboratory findings that rule out other neurological or medical disorders. Providing a thorough medical history and detailed description of symptoms is crucial for an accurate diagnosis. However, the diagnostic criteria for PANS are stringent, requiring the presence of specific symptoms and ruling out other potential causes.
Furthermore, PANS is often associated with infections, most commonly streptococcal (strep) infections, which can complicate diagnosis. PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is a subtype of PANS specifically linked to strep infections. The presence of a strep infection is a critical factor in distinguishing between PANS and PANDAS. However, documenting a strep trigger can be challenging due to the lag between the inciting infection and symptom onset, further complicating the diagnosis and potentially leading to misdiagnosis.
In conclusion, PANS is often misdiagnosed or overlooked due to its rarity, shared symptoms with other disorders, complex diagnostic criteria, and association with infections, particularly strep infections. To improve the accuracy of diagnosis, it is essential to raise awareness among medical professionals, refine diagnostic criteria, and consider the possibility of PANS when encountering children with sudden-onset neuropsychiatric symptoms.
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PANS is triggered by infections, metabolic disturbances, and inflammatory reactions
While the exact prevalence of PANS is unclear, estimates suggest that it affects approximately 1 in 200 children. The complexity of the diagnostic process, the lack of experience and awareness of PANS within the medical community, and the tendency for it to be overlooked or misdiagnosed contribute to the challenge of determining its precise prevalence.
PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome, is a clinically defined disorder characterized by the sudden onset of neuropsychiatric symptoms. These symptoms can include obsessions/compulsions, food restriction, depression, irritability, anxiety, and difficulty with schoolwork. The cause of PANS is unknown in most cases, but it is believed to be triggered by infections, metabolic disturbances, and inflammatory reactions.
Infections that have been associated with PANS include Group A Streptococcus and strep throat, peri-anal strep, and scarlet fever. These infections can lead to neuroinflammation and immune dysfunction, resulting in the onset of PANS symptoms. However, it is important to note that not all cases of PANS are preceded by a documented infection, and other immune triggers may be involved.
Metabolic disturbances and inflammatory reactions are also believed to play a role in triggering PANS. This may include defects in clearing Group A strep, resolving inflammation, differences in neurocircuitry, cytokine receptors in the brain, or abnormal expression of neurosignaling molecules during infection. Additionally, researchers have hypothesized that simultaneous exposure to multiple infectious organisms can override the immune system's natural defences or produce abnormal activation, leading to the onset of PANS symptoms.
While the exact mechanisms and triggers of PANS are not fully understood, the current understanding highlights the role of infections, metabolic disturbances, and inflammatory reactions in its development. Further research and comprehensive studies are needed to improve the understanding of the true prevalence and underlying causes of PANS.
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PANS shares symptoms with PANDAS, including OCD and tics
PANS and PANDAS are two interrelated conditions that affect the neuropsychiatric health of children. They are conditions of neuroinflammation and immune dysfunction, both characterised by the sudden onset of symptoms including obsessive-compulsive behaviours (OCD), anxiety, tics, and mood swings.
PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is triggered by a strep infection. It is believed that the immune system, instead of attacking the infection, targets a part of the brain called the basal ganglia, which affects thoughts, feelings, movement, and behaviours. This results in symptoms such as OCD, tics, anxiety, and other abnormal movements.
PANS, or Pediatric Acute-Onset Neuropsychiatric Syndrome, is triggered by other infections such as Lyme disease or influenza. It shares many symptoms with PANDAS, including OCD, tics, anxiety, and mood swings. PANS is characterised by the sudden onset of these symptoms, along with acute behavioural deterioration in at least two designated domains.
The prevalence of PANS and PANDAS is not exactly known, but estimates suggest that PANS affects around 1 in 200 children. PANDAS is believed to be less common, with estimates ranging from 5 to 10 per 1000 children. However, the true prevalence of these conditions may be higher due to underreporting and misdiagnosis.
Therapy, such as cognitive behavioural therapy and habit reversal training, can help children manage the symptoms of PANS and PANDAS. Antibiotics may also be used to treat active infections.
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PANS is treated with medicine and therapy
PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) is a rare and lesser-known disorder that often goes misdiagnosed or overlooked. It is characterised by the sudden onset of obsessive-compulsive symptoms (OCD) or eating restrictions, along with acute behavioural deterioration in at least two designated domains. The exact prevalence of PANS is unclear, but estimates suggest it affects around 1 in 200 children.
PANS is a complex condition that requires a comprehensive treatment approach, including medicine and therapy. The first step in treating PANS is to address the underlying infection(s) that triggered the condition. This typically involves antibiotic treatment to eliminate the infection and reduce inflammation. For example, antibiotics such as amoxicillin or penicillin are used to treat Group A Streptococcus (GAS) infections, which are commonly associated with PANS. Other medications may be prescribed to manage specific symptoms, such as anti-inflammatory drugs for inflammation or targeted nutrient therapy to support overall health and reduce exposure to triggers.
In addition to medical treatment, cognitive behavioural therapy (CBT) plays a crucial role in managing PANS. CBT for OCD is specifically designed to address the obsessive-compulsive tendencies and ritual behaviours associated with PANS. Exposure and response prevention therapy is a form of CBT that helps individuals confront their fears and rituals while learning healthier ways to respond. Habit reversal therapy is another effective approach, particularly for children with tics or other abnormal movements. Therapy can also help address the anxiety, mood swings, and other behavioural changes that may occur with PANS.
The Sancta Familia Center for Integrative Medicine takes an integrative approach to treating PANS by focusing on both the illness and the underlying behavioural and medical issues. They emphasise the importance of a comprehensive medical evaluation and laboratory assessment to identify the triggering infection(s) and develop a targeted treatment plan. This may include stool testing to address step species in the colon and ensure healthy bowel function, which is crucial for overall health.
While PANS is a complex and challenging condition, early diagnosis and a comprehensive treatment approach that includes both medicine and therapy can lead to effective management and improved well-being for affected individuals.
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Frequently asked questions
The exact prevalence of PANS is unknown, but estimates suggest that it affects approximately 1 in 200 children. Determining the precise prevalence of PANS presents a significant challenge due to the complexity of the diagnostic process and the lack of experience and awareness of PANS within the medical community.
PANS is characterised by the sudden onset of obsessive-compulsive symptoms (OCD) or eating restrictions, along with acute behavioural deterioration in at least two designated domains. Other symptoms include anxiety, sensory amplification or motor abnormalities, behavioural regression, deterioration in school performance, mood disorders, urinary symptoms and/or sleep disturbances.
PANS is diagnosed by a healthcare provider using specific criteria, including the sudden onset of OCD or severely restricted food intake, the sudden onset of at least two other neuropsychiatric symptoms, and a history of a strep infection within 3 months of symptom onset.
PANS can be treated with medicines and therapy, including cognitive behavioural therapy for OCD. Doctors and mental health experts can also provide guidance and support to help families get through challenging times.
