PANS/PANDAS 101
What is PANS?
PANS stands for Pediatric Acute-onset Neuropsychiatric Syndrome. It is a condition characterized by the sudden onset of significant neuropsychiatric symptoms in children, most notably obsessive-compulsive symptoms (OCD) and/or a severe restriction in eating.
​
The onset can be dramatic, with parents describing their child as seeming to change almost overnight. However, sometimes this change can be more gradual after an acute illness. Along with OCD or eating changes, children may experience anxiety, emotional changes, behavioral regression, sleep disturbances, urinary symptoms, sensory or motor changes, and difficulties with attention or school performance.
​
PANS is thought to involve inflammation and immune system dysfunction affecting the brain in at least some children, and symptoms may be triggered or worsened by infections, illness, or other inflammatory stressors.
What is PANDAS?
PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. It is considered a subset of PANS in which the sudden onset or worsening of neuropsychiatric symptoms is associated with a Group A streptococcal (strep) infection.
​
Children with PANDAS may suddenly or gradually develop symptoms such as OCD, tics, anxiety, emotional changes, behavioral regression, sleep disturbances, urinary symptoms, or changes in attention and school performance after or during a streptococcal infection.
​
The proposed mechanism involves an abnormal immune response to strep infection that may affect brain function and contribute to neuropsychiatric symptoms. Symptoms can follow a relapsing-remitting pattern, with flares occurring after new infections or immune challenges.
Common Signs & Symptoms of PANS/PANDAS
Symptoms often appear suddenly and dramatically, sometimes seemingly overnight. Common signs may include:
01
Sudden onset of OCD or obsessive-compulsive behaviors
04
​​Sudden food restriction, fear of eating, or changes in eating habits
07
Behavioral or developmental regression
10
Sensory sensitivities to sounds, lights, textures, clothing, or touch
13
Sudden decline in school performance
16
​Motor abnormalities or unusual movements
02
Severe anxiety, including separation anxiety
05
​​Emotional lability, frequent crying, or extreme mood swings
08
Sleep disturbances
11
Decline in handwriting or other fine-motor skills
14
​Hyperactivity or impulsivity
16
Physical symptoms such as joint pain, headaches, or fatigue
03
Tics or other unusual movements
06
Irritability, aggression, or rage
09
Urinary frequency, urgency, or new bedwetting
12
Difficulty with attention, concentration, or executive functioning
15
Depression or withdrawal