PANS most often refers to Pediatric Acute-onset Neuropsychiatric Syndrome, a childhood condition where obsessive–compulsive symptoms or severely restricted eating appear very suddenly, usually over a day or two.

Basic definition

PANS is defined by sudden onset of obsessive–compulsive disorder (OCD) or severe restriction of food intake in a child, together with at least two other new neuropsychiatric symptoms such as anxiety, mood changes, or sleep problems. It is considered a clinical syndrome, meaning doctors diagnose it from the pattern of symptoms rather than a single lab test.

Typical symptoms

Common associated symptoms include:

• Marked anxiety, mood swings, irritability, or depression.

• Sudden drop in school performance, new attention or memory problems, or regression in skills or behavior.

• Sleep disturbance, urinary frequency/bedwetting, tics, or new sensory sensitivities (for example to noise or light).

Causes and triggers

PANS is thought to be triggered by an abnormal immune or inflammatory response, often following infections, though metabolic or other inflammatory triggers are also reported. A related diagnosis, PANDAS, is considered a subset where symptoms are linked specifically to recent group A streptococcal infection such as strep throat.

Diagnosis and treatment

Diagnosis is clinical and usually made by pediatricians, child psychiatrists, or neurologists familiar with the syndrome, after ruling out other medical and psychiatric conditions. Management often combines treatment of any underlying infection or inflammation, psychiatric medications or therapy for OCD and anxiety, and educational and family support.

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