Pediatric acute-onset neuropsychiatric syndrome


Pediatric acute-onset neuropsychiatric syndrome is a clinically defined disorder characterized by the sudden onset of obsessive-compulsive symptoms or eating restrictions, concomitant with acute behavioral deterioration and/or motor/sensory changes in at least two of seven domains. Those domains are anxiety, emotional lability and/or depression, irritability, aggressive or oppositional behavior, academic decline, cognitive decline, and sleep disruption. The definitive diagnosis also necessitates a course that follows a relapsing–remitting pattern. In the case of post-puberty chronicity residual symptoms and their severity increases.

Diagnosis

PANS is an exclusively clinical diagnosis based on the exclusion of other disorders and is characterized by symptoms typical of basal ganglia dysfunction and the results of altered functions of the inert part of the immune system. PANDAS is basically PANS caused by streptococcal infection and has symptoms similar to PANS. However, the pathological mechanisms of PANDAS are still under research. Possible laboratory markers for PANDAS have been discussed and tested, with no promising results. PANS and PANDAS are, despite their similarity, not interchangeable concepts and terms.

PANS/PANDAS Research Consortium

A consortium of academic clinicians and scientists was convened in 2013 to develop more defined diagnostic guidelines for this disorder in anticipation of furthering research, clinical trials, and clinical care for this patient subgroup.