Symptoms and Signs of PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections)

Medical Author:
Medically Reviewed on 10/22/2021

Doctor's Notes on PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections)

PANDAS, which stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a pediatric disease characterized by sudden and dramatic symptoms of obsessive-compulsive disorder (OCD) and/or tic disorders, or worsening OCD, and/or tics following a strep infection.

PANDAS affects children from age 3 to puberty, and rarely, adolescents. Strep bacteria causes PANDAS. This bacteria causes scarlet fever and strep throat.

Symptoms and signs of PANDAS include obsessions and/or compulsions and motor and/or vocal tics. Other symptoms of PANDAS include the following:

  • ADHD symptoms (hyperactivity, inattention, and fidgeting)
  • Separation anxiety (child has difficulty separating from parents or caregivers)
  • Mood changes, such as irritability, sadness, anxiety attacks, excessive emotional reactions (affect lability) such as a tendency to laugh or cry unexpectedly or inappropriately
  • Trouble sleeping (insomnia)
  • Overnight bed-wetting and/or frequent daytime urination
  • Changes in motor skills (for example, changes in handwriting)
  • Joint pain

What Is the Treatment for PANDAS?

Firstly, the strep infection that precipitated the condition must be treated with antibiotics. Other treatments for PANDAS can include controlling the symptoms of obsessive-compulsive disorders with selective serotonin reuptake inhibitor (SSRI) medications.

For very severe cases, treatments have been studied that are directed at controlling the immune response. Examples include:

  • immunoglobulin treatments,
  • steroid medications, and
  • plasmapheresis (a procedure in which blood is withdrawn from an individual and the liquid portion is removed and replaced and the blood is transfused back into the individual).

Strep (Streptococcal) Throat Infection : Test Your Infectious Disease IQ Quiz

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REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.