What is PANS and PANDAS?

PANS and PANDAS are autoimmune conditions in children that cause sudden, severe neuropsychiatric symptoms following an infection or other immune trigger.¹,⁶ The brain becomes inflamed. The child you know seems to change overnight.

Two related conditions

PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections.¹,⁷ It was first defined by Dr. Susan Swedo at the National Institute of Mental Health in the 1990s, based on observations that some children developed sudden severe OCD and tics after strep infections.

PANS stands for Pediatric Acute-onset Neuropsychiatric Syndrome. It is the broader umbrella that covers the same kind of sudden onset triggered by other infections (mycoplasma, influenza, Lyme, viral illnesses) or non-infectious immune events.²,⁶

If your child's symptoms followed a strep infection, what you may be seeing is PANDAS. If they followed something else, or you cannot identify a clear trigger, PANS is the term clinicians use. Treatment overlaps significantly between the two.

What is happening inside the body

After a triggering infection, the immune system produces antibodies. In PANS and PANDAS, some of those antibodies appear to cross-react with brain tissue, particularly in the basal ganglia, an area involved in movement, behavior, and emotional regulation. The resulting inflammation drives the symptoms.¹,⁴

This is similar in mechanism to Sydenham chorea, a movement disorder long known to follow strep infections. PANS and PANDAS are conceptually in the same family of post-infectious autoimmune brain conditions.⁶

Both are treatable

With the right combination of approaches, most children improve significantly. Treatment generally follows a three-pronged framework recommended by the PANS Research Consortium:³,⁴,⁵

• Treat the infection (antibiotics where appropriate)
• Address the immune response (anti-inflammatory medications, in some cases IVIG or plasmapheresis for severe cases)
• Support psychiatric and behavioral symptoms (cognitive behavioral therapy, sometimes medications, parent training)

The work of finding a clinician who knows this framework is real and often falls on parents. The Advocate section of this site is for exactly that work.