What PANDAS Syndrome?

PANDAS Syndrome (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is a childhood-onset neuropsychiatric disorder characterized by the sudden onset of debilitating symptoms, such as obsessive-compulsive disorder (OCD), tics, and severe anxiety, following a streptococcal infection, such as strep throat or scarlet fever.

Children with PANDAS typically experience an abrupt onset of symptoms, often within days or weeks of a strep infection. These symptoms can include:

* Severe OCD, characterized by intrusive thoughts and compulsive behaviors

* Tics, which can range from simple motor tics (e.g., eye blinking, shoulder shrugging) to complex vocal tics (e.g., throat clearing, coprolalia)

* Anxiety, which can range from mild to severe and may be accompanied by panic attacks

* Emotional lability, with sudden shifts in mood and irritability

* Difficulty concentrating and paying attention

* Regression in developmental skills

* Hyperactivity and impulsivity

The exact cause of PANDAS Syndrome is not fully understood, but it is believed to be related to an autoimmune response triggered by strep infections. In individuals with PANDAS, the immune system mistakenly attacks the brain and basal ganglia, leading to the sudden onset of neuropsychiatric symptoms.

The diagnosis of PANDAS Syndrome is based on the presence of the following criteria:

* Abrupt onset of symptoms within days or weeks of a strep infection

* Obsessive-compulsive symptoms or tics as the predominant symptoms

* Other neuropsychiatric symptoms, such as anxiety, emotional lability, difficulty concentrating, and regression in developmental skills

* Evidence of a recent strep infection, such as elevated anti-streptococcal antibodies or a positive throat culture

Treatment for PANDAS Syndrome typically involves antibiotics to clear the strep infection and immunomodulatory therapies, such as intravenous immunoglobulin (IVIG), to reduce the immune response. Behavioral therapy, such as cognitive-behavioral therapy (CBT), may also be helpful in managing symptoms of OCD, anxiety, and tics.

PANDAS Syndrome is a complex and challenging condition, but with proper treatment, many children can experience significant improvement in their symptoms and overall well-being.