Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections (PANDAS) and OCD
By Susan Boaz
“My child woke up different. It was like a switch was flipped.” That is often how parents describe the sudden onset of OCD and other symptoms that appear with PANDAS.
A defining symptom of PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections), and its umbrella syndrome PANS (Pediatric Acute-onset Neuropsychiatric Syndrome), is the OCD that occurs suddenly and severely. Worries, fears, reassurances, and anxiety surge in a very short amount of time. Traditional OCD is different in that the obsessions and compulsions gradually get more severe over a longer course of time.
Parents of PANDAS and PANS children have also described how their once independent child may no longer be able to leave the parent’s side because of separation anxiety, new sensory and motor abnormalities developed, and a refusal to eat. There are usually a variety of behavior changes that simultaneously occur making it a scary experience for the entire family.
- For a diagnosis of PANDAS, evidence of strep is required. Comorbid symptoms may give additional clues that support the diagnosis.
- PANS, however, can be triggered by a variety of infections and does not require evidence of strep. With PANS, comorbid symptoms are required for the diagnosis. A child must have 2 of the following comorbid symptoms, in addition to sudden onset of OCD or Disordered Eating:
- Emotional Lability and/or Depression
- Irritability, Aggression, and/or Severe Oppositional Behaviors
- Behavioral (Developmental) Regression
- Sudden Deterioration in School Performance
- Motor or Sensory Abnormalities
- Somatic Signs and Symptoms, including Sleep Disturbances, Enuresis, or Urinary Frequency
When this happens, a visit to a physician is warranted. Physicians can perform tests to determine if the child has strep or another infection triggering the sudden behavior changes. It is important to remember that just because a child does not feel sick does not necessarily mean an infection is not present. Sometimes infections can occur without actually causing a fever or malaise.
The good news is PANDAS and PANS can be treated. Children can get better and symptoms can resolve with appropriate medical interventions.
For more information on PANDAS and PANS, please visit the PANDAS Physicians Network at www.pandasppn.org.
DISCLAIMER: The content found here is intended to serve as educational content and is not intended to replace therapy. For treatment-related questions, please be sure to work with your local provider or contact a local clinician.