Understanding PANS/PANDAS
Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) are disorders characterized by the sudden onset of obsessive-compulsive disorder symptoms (OCD) or eating restrictions in children before reaching puberty. PANDAS is a subset of PANS that occurs in connection with infections caused by streptococcal (strep) bacteria, such as strep throat or scarlet fever. These disorders are thought to be an autoimmune problem, which is when the immune system malfunctions and creates antibodies that attack and cause damage to a part of the body (in this case, the nerve cells).
Symptoms of PANS/PANDAS
Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) share many of the same symptoms and may include sudden and severe onset of obsessive-compulsive disorder symptoms (OCD), severe food restrictions, significant changes in behavior, mood, sensory functioning (for example, touch, sound, noise), motor functioning (for example, handwriting), irritability, sleep disturbances, bed-wetting, separation anxiety, and joint pain.
Diagnosing PANS/PANDAS
PANS/PANDAS is diagnosed by clinical exam and features. PANDAS is associated with Streptococcus infection and laboratory tests may be performed to detect current or past infection. It is believed PANS may be triggered by an infection. PANDAS first becomes evident between the ages of 3 years and puberty. There is no age requirement with PANS.
Treating PANS/PANDAS
Treatment focuses on addressing the underlying cause, managing symptoms, and supporting the immune system and may consist of anti-infectives to treat infection, medications to help with certain symptoms, and behavioral counseling. Treatment of severe PANS/PANDAS may include immune globulin therapy administered into the blood stream intravenously (IVIG).
References:
- What Is PANS/PANDAS? | PANDAS Physician Network
- PANDAS-Questions and Answers | National Institute of Mental Health
Last reviewed 12/16/2025
