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PANDAS syndromes are autoimmune

Frequently asked questions about PANDAS ( Autistic disorder & Obsessive Compulsive disorder). 13 answers

Q. Is there a test for PANDAS?

A. No. The diagnosis of PANDAS is a clinical diagnosis, which means that there are no lab tests that can diagnose PANDAS. Instead clinicians use 5 diagnostic criteria for the diagnosis of PANDAS (see below). At the present time the clinical features of the illness are the only means of determining whether or not a child might have PANDAS.

Q. What are the diagnostic criteria for PANDAS?

A. They are:

  1. Presence of Obsessive-compulsive disorder and/or a tic disorder
  2. Pediatric onset of symptoms (age 3 years to puberty)
  3. Episodic course of symptom severity
  4. Association with group A Beta-hemolytic streptococcal infection (a positive throat culture for strep. or  history of Scarlet Fever.)
  5. Association with neurological abnormalities (motoric hyperactivity, or adventitious movements, such as choreiform movements)

Q. What is an episodic course of symptoms?

A. Children with PANDAS seem to have dramatic ups and downs in their OCD and/or tic severity. Tics or OCD which are almost always present at a relatively consistent level do not represent an episodic course. Many kids with OCD or tics have good days and bad days, or even good weeks and bad weeks. However, patients with PANDAS have a very sudden onset or worsening of their symptoms, followed by a slow, gradual improvement. If they get another strep. infection, their symptoms suddenly worsen again. The increased symptom severity usually persists for at least several weeks, but may last for several months or longer. The tics or OCD then seem to gradually fade away, and the children often enjoy a few weeks or several months without problems. When they have another strep. throat infection  the tics or OCD return just as suddenly and dramatically as they did previously.


Q. Are there any other symptoms associated with PANDAS episodes?

A. Yes. Children with PANDAS often experience one or more of the following symptoms in conjunction with their OCD and/or tics:

  1. ADHD symptoms (hyperactivity, inattention, fidgety)
  2. Separation anxiety (Child is “clingy” and has difficulty separating from his/her caregivers. For example, the child may not want to be in a different room in the house from his/her parents.)
  3. Mood changes (irritability, sadness, emotional lability)
  4. Sleep disturbance
  5. Night- time bed wetting and/or day- time urinary frequency
  6. Fine/gross motor changes (e.g. changes in handwriting)
  7. Joint pains

continue to  Strep. throat, tics or OCD