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PANS/PANDAS

What is PANS/PANDAS?

Pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) are diagnoses that often include the sudden onset of obsessive compulsive disorder (OCD) or eating restrictions as well as symptoms from at least two of seven categories. PANS/PANDAS are diagnoses of exclusion so it is important to rule out other possible medical and psychiatric diagnoses.

The most common symptoms include:
- Obsessive compulsive disorder (OCD)
- Eating restrictions
- Anxiety (separation anxiety in particular)
- Emotional lability and/or depression
- Irritability, aggression and/or severely oppositional behaviors
- Behavioral (developmental) regression
- Deterioration in school performance (related to attention-deficit hyperactivity disorder-like behaviors, memory deficits and cognitive changes)
- Sensory or motor abnormalities
- Somatic signs and symptoms, including sleep disturbances, enuresis or urinary frequency
At Children’s National Hospital, child psychologists, psychiatrists, neurologists or infectious disease doctors may all interview the child or adolescent and his or her parents. We may have the patient and family fill out questionnaires about different aspects of the child’s or adolescent’s life, including physical health concerns, difficulties at school or behavior with friends and family. The medical team will rule out other medical diagnoses via examination, bloodwork or MRI scans.
Following a full assessment, a member of the Children’s National care team will discuss treatment options with the child or adolescent and his or her family. Cognitive behavioral treatment (CBT), certain types of medicines and antibiotic courses are effective in treating PANS/PANDAS in children.
- CBT includes working with a therapist to help the child or adolescent (and his or her family) learn how to cope with feelings of anxiety and how to handle behavioral change and emotional lability. During treatment, patients learn to gradually face their worries and learn how to manage their anxiety, both during and between flares.
- Medications, such as selective serotonin reuptake inhibitors, may be recommended. These medicines affect neurotransmitters (nerve cells in the brain that carry signals) linked to anxiety.

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PANS/PANDAS

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What is PANS/PANDAS?