Debate on Pediatric Acute-onset Neuropsychiatric Syndrome and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections

What are PANS and PANDAS?

Some children develop a range of behavioural, emotional and physical symptoms following an infection. These can include symptoms of obsessive compulsive disorder, restricted eating and tics.

Paediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) are diagnoses that have been proposed to explain the sudden development of these symptoms.

Currently, there is no overall medical consensus about the definition of these conditions and cause of these symptoms in children.

Diagnostic criteria and treatment options for PANS and PANDAS have been proposed by researchers and clinicians, but are based on limited evidence and many have called for more research.

How are PANS and PANDAS diagnosed and treated in the UK?

There is currently no guidance on the diagnosis and treatment of these conditions in the NHS.

In 2022, the PANS PANDAS Working Group (PPWG) was established. This group includes representatives from healthcare professional bodies and royal colleges, the PANS PANDAS UK charity, and patients and their families. It aims to develop recommendations to reduce variation in, and improve, the diagnosis and treatment of children who present with acute-onset neuropsychiatric symptoms in the NHS.