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.