Replies

PANDAS is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections.

This diagnosis is used to describe a set of children who have a rapid onset of obsessive-compulsive disorder (OCD) and/or tic disorders such as Tourette syndrome (TS), following group A beta-hemolytic streptococcal (GABHS) infections such as “strep throat” and scarlet fever.

The proposed link between infection and these disorders is an autoimmune reaction, where antibodies produced by the infection interfere with neuronal cells.

[snip]

According to the National Institute of Mental Health (NIMH), children with PANDAS are clinically identified by five criteria. “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).”[1]

The children usually have dramatic, “overnight” onset of symptoms, including motor or vocal tics, obsessions, and/or compulsions.[1]

Some studies have shown no acute exacerbations associated with streptococcal infections among clinically defined PANDAS subjects[8][9] whilst others have shown a profound one.[10][11]

In addition to an OCD or tic disorder diagnosis, children may have other symptoms associated with exacerbations such as emotional lability, enuresis, anxiety, and deterioration in handwriting.[11] In the PANDAS model, this abrupt onset is thought to be preceded by a strep throat infection.

As the clinical spectrum of PANDAS appears to resemble that of Tourette’s syndrome, some researchers hypothesize that PANDAS and Tourette’s may be associated; this idea is controversial and a focus for current research.[3][12]

Concerns have been raised that PANDAS may be overdiagnosed, as nearly one-third of patients diagnosed with PANDAS by community physicians did not meet the criteria when examined by specialists, suggesting that the PANDAS diagnosis is conferred by community physicians without conclusive evidence.[13]

http://en.wikipedia.org/wiki/PANDAS