Diagnostic Criteria for PANS

PANS is diagnosed using the following criteria:

  • Sudden & acute onset of OCD or severely restricted food intake.
  • Concurrent severe & abrupt onset of symptoms from at least 2 of the neuropsychiatric categories below:
    • Anxiety, Separation Anxiety
    • Emotional Lability, Depression
    • Aggression, Irritability, Oppositional Behavior
    • Behavioral/Developmental Regresion
    • Deterioration of learning abilities related to ADHD
    • Sensory & Motor Abnormalities
    • Somatic Signs: sleep disturbances, enuresis, urinary frequency
    • Symptoms not better explained by a known medical or neurological disorder. It is a "diagnosis of exclusion".
  • There is no age requirement, typically symptoms start during grade school but post-pubertal cases are not excluded.

Additional Notes on PANS:

  • Can have Motor & Phonic tics (whooping, wringing hands)
  • Can have episodes of extreme anxiety or aggression. 
  • Can have visual or auditory hallucinations identical to the psychotic symptoms seen in conditions such as schizophrenia, bipolar disorder, and lupus cerebritis.
  • Can have a decline in handwriting & math skills.

Diagnostic Criteria for PANDAS

PANDAS is diagnosed using the following criteria:

  • Significant OCD and/or debilitating/incapacitating Tic symptoms
  • Pediatric Onset – Symptoms have an evident onset between 3 years of age and puberty but post pubertal onset is possible. Pediatric onset specified as it is time of peak exposure and cross-species immunity of GAS infections.
  • Acute onset and episodic course: Defined as either a dramatic onset of OCD or tic symptoms or by relapsing-remitting symptoms that erupt with an acute change. Between episodes, symptoms may lesson but not return to pre-syndrome levels.
  • Associated with Streptococcal-A (GABHS) infection. Note: not all patients will have pharyngitis; strep may be in locations other than throat or patient may be a carrier without active infection. Secondary triggers can be due to exposure to strep or other pathogens.
  • Neurologic abnormalities (motoric hyperactivity, choreiform movement) during symptom exacerbation

 Additional Notes on PANDAS:

  • In conjunction to OCD and/or tics, patients often concurrently experience the comorbid neuropsychiatric symptoms seen in PANS with the same acute and dramatic onset.