PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. It is a controversial hypothetical diagnosis for a subset of children with rapid onset of obsessive-compulsive disorder (OCD) or tic disorders. PANDAS is hypothesized to be an autoimmune disorder that results in a variable combination of tics, obsessions, compulsions, and other symptoms with sudden or abrupt onset that may be severe enough to qualify for diagnoses such as chronic tic disorder, OCD, and Tourette syndrome.

The cause of PANDAS is thought to be similar to that of Sydenhams chorea (SC), which is known to result from childhood group A streptococcal (GAS) infection leading to the autoimmune disorder rheumatic fever of which SC is one manifestation. Some providers think 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.

The symptoms of PANDAS 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. Children with PANDAS suddenly show signs of obsessive-compulsive disorder (OCD) tics, or both. The changes to their personality and behavior are quick and dramatic; they start abruptly and closely after a strep throat infection.

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. At the present time, the clinical features of the illness are the only means of determining whether a child might have PANDAS. The diagnostic criteria include the presence of OCD, a tic disorder, or both, and a very close relationship between the abrupt onset or worsening of OCD, tics, or both, and a strep infection.

Treatment for PANDAS may include cognitive-behavioral therapy for behavioral problems and habit reversal training for tics, which helps decrease the frequency of symptoms and provides children with the tools to manage their symptoms. Antibiotics may also be prescribed to treat the strep infection. The best way to prevent any illness thought to be associated with an infection is to prevent the infection from occurring in the first place. Encouraging children to practice good hygiene is one way to prevent strep infections.