PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. It is a term for a disorder in children who have obsessive-compulsive disorder (OCD), tic disorders, or both, and who suddenly develop symptoms or have symptoms worsen after being infected with "strep" bacteria (Group A beta-hemolytic streptococcus or Group A Strep) . The symptoms are usually dramatic, happen "overnight and out of the blue," and can include motor or vocal tics or both and obsessions, compulsions, or both. In addition to these symptoms, children may become moody or irritable, experience anxiety attacks, or show concerns about separating from parents or loved ones.

PANDAS is considered a pediatric disorder and typically first appears in childhood from age 3 to puberty. Reactions to strep infections are rare after age 12, but researchers recognize that PANDAS could occur, though rarely, among adolescents. It is unlikely that someone would experience these post-strep neuropsychiatric symptoms for the first time as an adult, but it has not been fully studied. It is possible that adolescents and adults may have immune-mediated OCD, but this is not known.

The underlying cause of PANDAS is thought to be attributed to an autoimmune attack of healthy brain tissue after a strep infection. Some believe that PANDAS occurs when a childs immune system produces antibodies to fight the bacteria that caused a strep infection. But the antibodies may also mistakenly attack healthy cells in other tissues because the cells mimic those of the strep infection. Some believe that antibodies affect tissues in a childs brain, leading to the psychological and neurological symptoms sometimes reported.

PANDAS is diagnosed by a healthcare provider after evaluating the patient. Although laboratory testing cannot identify PANDAS, it might identify a Group A Strep infection, which precedes PANDAS. The diagnosis of PANDAS is a clinical diagnosis, which means that there are no lab tests that can diagnose PANDAS. Instead, health care providers use diagnostic criteria for the diagnosis of PANDAS. The diagnostic criteria include the presence of OCD, a tic disorder, or both, prepubertal onset of neuropsychiatric symptoms, a history of a sudden onset of symptoms and/or an episodic course with abrupt symptom exacerbation interspersed with periods of partial or complete remission.

Treatment for PANDAS may include cognitive-...