PANS and PANDAS – symptoms beyond OCD and tics – a systematic review

Abstract

This article aims to describe the symptomatology of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), and to highlight some of their potential distinctive features, by juxtaposing available data with existing literature on pediatric obsessive - compulsive disorder (OCD).

Given the scarcity of high-quality studies, we decided to review a wide range of publications on the clinical presentation of PANS and PANDAS, including case series and case reports, regardless of their methodological heterogeneity.

Although PANS and PANDAS share many characteristics with non-PANS/PANDAS OCD, the acute onset of obsessive-compulsive symptoms in conjunction with concomitant features, especially separation anxiety, irritability, emotional lability, or dysgraphia should prompt consideration of a possible post-infectious etiology. Further research aimed at creating more precise diagnostic tools is needed to facilitate differential diagnosis.