Overview
Pediatric acute-onset neuropsychiatric syndrome (PANS) is characterized by the sudden onset of obsessive-compulsive disorder (OCD) symptoms or severely restricted food intake, accompanied by other neurological, behavioral, or psychiatric symptoms.
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a subtype of PANS that develops following a group A streptococcal (strep) infection. Although the exact cause remains unknown, researchers believe an abnormal immune response triggered by infections or other environmental factors may contribute to the development of these conditions in susceptible children.
Common Symptoms
Sudden onset of obsessive-compulsive disorder (OCD), restrictive eating, anxiety, mood swings, emotional lability, irritability, aggression, motor or vocal tics, sensory sensitivities, sleep disturbances, bedwetting or increased urinary frequency, decline in school performance, difficulty concentrating, and behavioral regression.
Coexisting Diseases and Conditions
Conditions that may coexist with or resemble PANS/PANDAS include obsessive-compulsive disorder (OCD), Tourette syndrome, attention-deficit/hyperactivity disorder (ADHD), autoimmune encephalitis, Sydenham’s chorea, anxiety disorders, depression, and eating disorders.
Risk Factors and Prevalence
PANS and PANDAS most commonly affect children between the ages of 3 years and puberty. PANDAS is specifically associated with a preceding group A streptococcal infection, while PANS may be triggered by other infections, environmental factors, or unknown causes. A family history of autoimmune disease, psychiatric disorders, or neurodevelopmental conditions may increase susceptibility.
Recent Research
Want to learn more? Read our in-depth article, PANDAS, PANS, and Autoimmunity, to explore the science behind these conditions, expert insights, diagnosis, treatment, and the latest research.
- Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): Clinical Report (2025)
- Obsessive-compulsive disorder in PANS/PANDAS in children: In search of a qualified treatment– A systematic review and metanalysis (2022)
- The COVID-19 pandemic and children with PANS/PANDAS: an evaluation of symptom severity, telehealth, and vaccination hesitancy (2022)
- Disruptions and adaptations in family functioning: A study of families’ experiences with PANS/PANDAS (2022)
- Severe psychotic symptoms in youth with PANS/PANDAS: Case-Series (2020)
Sources
- Sources
Rea, I., Guido, C. A., & Spalice, A. (2021). Clinical features in patients with PANDAS/PANS and therapeutic approaches: a retrospective study. Frontiers in neurology, 12.
La Bella, S., et al. (2023). Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS): Myth or reality? The state of the art on a controversial disease. Microorganisms, 11(10).
Gagliano, A., Carta, A., Tanca, M. G., & Sotgiu, S. (2023). Pediatric acute-onset neuropsychiatric syndrome: current perspectives. Neuropsychiatric Disease and Treatment, 1221-1250.
Prato, A., Gulisano, M., Scerbo, M., Barone, R., Vicario, C. M., & Rizzo, R. (2021). Diagnostic approach to pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS): a narrative review of literature data. Frontiers in Pediatrics, 9.
Board of Directors [From the American Academy of Pediatrics]. (2025). Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): Clinical Report. Pediatrics, 155(3).