What Does PANS Look Like in Children?

“What this is not is garden variety OCD, Tourette’s, ADHD, conduct disorder — anything else,” explains Dr. Swedo. “We’re talking about a six-year-old, seven-year-old, maybe as young as three or four, who undergoes an acute behavioral change, a very, very dramatic onset.”

Acute onset OCD might take the form of a child suddenly asking for constant reassurance, or engaging in endless handwashing. Many children with PANS become obsessive about food, severely restricting what they will eat because of acute fears of contamination, choking or vomiting. This can develop into anorexia, and can result in extreme weight loss, necessitating hospitalization and the use of a feeding tube.

Separation anxiety can also appear suddenly, sometimes so overwhelming that a 10-year-old, or even a 14-year-old suddenly has to start sleeping with his mother. And panic attacks are common. “In those first few days, the child is in state of near-constant panic,” Dr. Swedo adds. “These changes are not subtle.”