Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)
- Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) most commonly present as obsessive-compulsive disorder (OCD) and/or tic disorder developing abruptly or acutely worsening during or following a group A β-hemolytic Streptococcus (GABHS) infection.
- Proposed associations are GABHS pharyngitis or skin/soft tissue infection.
- Symptoms begin abruptly (hours) and peak by 24 to 48 hours.
- Symptoms include motor tics, vocal tics, obsessions and/or compulsions, anxiety attacks, separation anxiety, bed wetting, and hyperactivity.
- It remains unclear if PANDAS represent a true entity distinct from similar disorders in children.
- Unknown, thought to be rare
- Considered a subset of pediatric acute-onset neuropsychiatric syndrome (PANS); abrupt onset of OCD and associated symptoms not better explained by a known neuropsychiatric condition (1)
- GABHS infection likely accounts for a small proportion of antecedent exacerbations among patients meeting diagnostic criteria for PANS (1).
Etiology and Pathophysiology
- Streptococcal infection
- Tic disorder, Tourette syndrome, OCD
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