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Pandas and Pans

PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. This disorder occurs when strep triggers a misdirected immune response in a child and then it results in inflammation on a child’s brain.Strep

PANS is an acronym for Pediatric Acute-onset Neuropsychiatric Syndrome, which is associated with a variety of different infections, whereas PANDAS is a disorder associated with only streptococcal infections—specifically group A strep. Although the etiology for PANS is different from PANDAS the symptom presentation is nearly identical.

Children with PANDAS quickly begin to exhibit life changing symptoms such as OCD, anxiety, tics, personality changes, sensory sensitivities, restrictive eating, and decline in math and handwriting abilities, and more.

This was a little known disorder until the past few years. However, PANDAS Network estimates that PANDAS/PANS affect as many as 1 in 200 children. There may be many children with PANDIS/PANS who are misdiagnosed with other disabilities.

The hallmark trait for PANDAS is sudden acute and debilitating onset of intense anxiety and mood change accompanied by Obsessive Compulsive-like issues and/or Tics in association with a streptococcal-A (GABHS) infection that has occurred immediately prior to the symptoms. In some instances the onset will be 4 to 6 months after a strep infection because the antibiotics did not fully eradicate the bacteria. Many pediatricians do not know the latent variability of strep. However rheumatologists and streptococcal experts do.

PANS patients will present with:PANDAS patients will present with:
  • Anxiety
  • Presence of significant obsessive compulsive disorders and or tics
  • Emotional instability and depression
  • Abrupt onset of symptoms or a relapse of symptom severity
  • Developmental behavioral regression
  • Prepubertal onset
  • Deterioration in school performance
  • Association with strep infections
  • Sensory and or motor abnormalities
  • Association with other neuropsychiatric symptoms (including any of the PANS accompanying symptoms)
  • Irritability, depression and or severely oppositional behaviors
  • Somatic signs including sleep disturbances
  • Poor bladder control

The onset of PANS may start with infectious agents other than strep or be brought on by environmental triggers or immune dysfunction. By contrast, the onset of PANDAS is always associated with just Streptococcal Infections.

These students struggle a great deal in school and often need either a Section 504 Plan accompanied by a Positive Behavior Intervention Plan or and IEP accompanied by a Positive Behavior Intervention Plan to monitor their behavior and help them maximize their school performance.

Pandas and Pan

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