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What happens during a PANDAS episode

During a PANDAS episode, a child will experience the sudden onset of OCD(Obsessive Compulsive Disorder) which include obsessions and compulsions, there may also be motor or vocal tics present.  Consult your family physician, emergency room doctor or psychologist for a proper diagnosis.

For a PANDAS diagnosis to be made the following must be determined:

          Symptoms occur or worsen during or after a strep infection

          PANDAS affects children between the ages of 3 and puberty

A list of possible PANDAS symptoms as compiled by the National Institutes of Mental Health:  

  • Sudden onset ("as if out of the blue") of Obsessive Compulsive Disorder symptoms or the worsening of symptoms in those children already affected by OCD
  • A sudden development of a nervous system disorder including tics but not limited to other rapid, jerky movements such as hyperactivity or restlessness or a worsening of a tic disorder in a child already diagnosed 
  • Full scale intensity of the OCD/tic symptoms occur within 24-48 hours 
  • ​Sudden unexplainable rages(emotional liabilty)
  • ADHD that is new or dramatically worsens in a child that was previously diagnosed
  • Anorexia (because of a fear of choking or throwing up)
  • immature behaviours such as "baby-talk"
  • Severe separation anxiety (ie: the child can't leave the parents side and may insist on sleeping in parents bed)
  • Defensiveness caused by hyperactive senses, (such as sensitivity to clothing, noise, light, taste,etc) which may be accompanyied by visual or auditory hallucinations
  • Noticeable decrease in handwriting, math or visual-spatial skills

  • Frequent urination
  • General anxiety which may progress to episodes of panic or a "terror stricken look"
  • The abrupt onset of depression which may include thoughts of suicide

Image courtesy of Susan E. Swedo, James F. Leckman, and Noel R. Rose from their paper: From Research Subgroup to Clinical Syndrome: Modifying the PANDAS Criteria to Describe PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). Pediatrics & Therapeutics 2:113. doi:10.4172/2161-0665.1000113

Click on the Links below to read more about a PANDAS diagnosis​

National Institutes of Mental Health (Maryland, USA): ​

Behavioural Neurotherapy Clinic (Australia):

International OCD Foundation:

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