PANDAS and PANS

What Are PANDAS and PANS?

PANDAS and PANS cause a sudden onset of severe OCD symptoms. They also cause other sudden changes in a child's behavior. These can be so extreme that a parent may say their child seemed to "change overnight."

PANS and PANDAS can be treated with medicines and therapy. Doctors and mental health experts can also give families guidance and support to help get through the challenging times.

What Are the Symptoms of PANDAS and PANS?

Kids with PANDAS and PANS will have sudden and severe obsessions, compulsions, or both.

Obsessions. A child may have new and intense fears. Or new and intense concerns about things being even, clean, dirty, or a set way. Stressful thoughts or images may come to mind over and over. These fears, thoughts, and concerns can be so strong that a child may be hard to comfort.

Compulsions (rituals). A child may wash, touch, do, or repeat things, and feel unable to stop. For example, they may walk in and out of a doorway many times, trying to do it "right." They may ask a parent for reassurance over and over.

Kids with PANDAS and PANS will also have other new symptoms. These can include:

• tics or jerky movements
• anxiety, depression, or mood swings
• acting aggressive or "hyper"
• using baby talk, acting clingy, or having new bedtime fears
• sudden trouble with handwriting or other fine motor skills
• new trouble with memory, reading, or math
• new bedwetting, not sleeping
• new fears about foods, eating, or choking; not eating
• new sensitivity to noise, touch, clothes, or light

What Causes PANDAS and PANS?

Experts believe PANDAS and PANS happen because of a problem with the immune system's response to an infection.

Instead of attacking the germs, the immune system targets a part of the brain by mistake. This part of the brain is called the basal ganglia. It affects thoughts, feelings, movement, and other behaviors. Experts believe irritation in this part of the brain leads to the symptoms.

What's the Difference Between PANDAS and PANS?

The most common cause of a severe onset of OCD and tics is a group A streptococcus ("strep") infection. When it's clear that a child's symptoms are linked to a strep infection (like strep throat), it's called PANDAS. It stands for Pediatric Acute-onset Neuropsychiatric Disorders Associated with Streptococcus.

PANS is when the severe onset of OCD symptoms is linked to another infection. These include the flu, chickenpox, mycoplasma, and Lyme disease. PANS stands for Pediatric Acute-onset Neuropsychiatric Syndrome.

How Do Doctors Diagnose and Treat PANDAS and PANS?

Most children with OCD did not get it because of PANDAS or PANS.

To diagnose PANDAS or PANS, doctors will take time talking to you and asking questions about your child's symptoms. They will do an exam and test for infections.

Treatment starts with medicine to take care of the infection.

Treatment also includes cognitive behavioral therapy for OCD. This is done by a trained mental health provider. Your child's doctor can refer you to the right person.

Therapy for OCD includes exposure and response prevention. This part of therapy reduces the ritual behaviors.

Therapy can also address other behavior and mood symptoms that may be part of PANDAS or PANS. For example, a therapy called habit reversal can help if a child has tics.

Therapists work closely with parents to coach them in ways to help their child's symptoms improve. Therapists also guide parents on how to manage a child's stressful symptoms until they can resolve.

Are PANDAS and PANS Contagious?

No. PANDAS and PANS are not contagious. Kids can't catch them from someone else. Both PANDAS and PANS are rare.

How Can I Help My Child?

If you think your child may have PANDAS or PANS, contact your child's doctor right away.

It's best to start therapy as soon as you can. Your doctor can help you find a mental health therapist. Or visit the International OCD Foundation website to find an expert who is trained to provide cognitive behavioral therapy for OCD in children.

To help your child get better:

• Start working with a therapist right away.
• Make sure your child does not miss any therapy sessions.
• Ask the therapist about the best ways to comfort or soothe your child.
• Give your child all the medicines your doctors recommend.
• Give your child a new toothbrush to be sure all the germs are gone.

Watching a child go through symptoms of PANDAS or PANS is stressful and challenging. Your care team is there to support and guide you. Lean on them for help and advice.