What Are PANS and PANDAS?

When children suddenly develop full-blown OCD and these associated symptoms, it may be what’s called PANS — pediatric acute-onset neuropsychiatric syndrome. It’s called “acute onset” because the behavior changes come on suddenly, reaching full-scale intensity within 24 to 48 hours. It’s a syndrome because there are quite a few other symptoms that appear alongside the intense anxiety.

If the onset of these symptoms is linked to a strep infection, it’s called PANDAS — pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections — which is a subgroup of PANS. Some 86 percent of acute onset OCD cases are linked to strep. Children especially at risk are those who have what doctors call “occult” or hidden strep infections — that is, children who can be “carriers” of the infection but don’t get symptoms themselves, and hence don’t get treatment.

PANS cases have also been linked to other infections, including Lyme disease, mononucleosis, mycoplasma (walking pneumonia) and the flu (such as H1N1).

PANS and PANDAS are episodic disorders. Symptoms may disappear for extended periods then reappear, stimulated by a later exposure to strep of some other bacteria or virus. Symptoms may get increasingly severe with multiple recurrences.