Pediatric acute-onset neuropsychiatric syndrome: A single-center retrospective study

Abstract

Aim

To facilitate the diagnosis of Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) in children, we described the clinical features of a PANS cohort and analyzed whether immunotherapy could shorten the symptom duration.

Methods

We retrospectively analyzed the medical records of children with PANS at the Children's Hospital of Chongqing Medical University and categorized them into two groups on the basis of whether they received immunotherapy to compare symptom duration.

Results

Forty-two patients were included. Thirty-three children (76.2 %) had infection within 4 weeks before onset. Thirty-six (88.1 %) children had obsessive‒compulsive symptoms, 5 children (11.9 %) had eating disorders, and one child had both. Other common clinical manifestations included sleep disturbances (76.2 %, 32/42), academic difficulties (73.8 %, 31/42), irritability (66.7 %, 28/42), developmental regression (54.8 %, 23/42), motor abnormalities (52.4 %, 22/42), hallucinations (52.4 %, 22/42), anxiety (50 %, 21/42), aggression (40.5 %, 17/42), hyperesthesia (31.0 %, 13/42), and emotional lability (23.8 %, 10/42). One child had epileptiform discharges on the electroencephalogram (EEG), while the other 41 children had normal EEGs. Brain magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) analysis were normal in all the children. Immunotherapy was used in 12 patients, and there was not a significant difference in symptom duration between the two groups (immunotherapy group: median 17, IQR 14–21; nonimmunotherapy group: median 15, IQR 11–20; p = 0.275).

Conclusions

PANS is usually triggered by infection and is accompanied by a variety of neuropsychiatric symptoms. In our retrospective small-sample study, immunotherapy did not shorten the duration of symptoms in children with PANS. However, further prospective studies are still needed to confirm its effectiveness.