PANS is an acronym for Pediatric Acute-onset Neuropsychiatric Syndrome. PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Strep. PANDAS is generally considered a subset of PANS.

Both disorders are the result of a misdirected immune response following an infection or illness. Children with PANDAS or PANS experience an acute onset of debilitating neuropsychiatric symptoms.


Separation anxiety

General anxiety



Emotional Lability

Sadness and Depression

Sleep Disturbances

Night-time Bed Wetting

Day-time Urinary Frequency

Fine/Gross Motor Changes (handwriting)

Deterioration in School Performance

Joint Pains

Behavioral Regression

Motor and/or Vocal Tics

Oppositional Behaviors

Irritability and/or Aggression

Sensory or Motor Abnormalities

Food Restriction


PANS is defined by the following criteria:

Abrupt, dramatic onset of OCD or severely restricted food intake; symptoms are not better explained by a known neurologic or medical disorder; and the addition of at least two of the “accompanying” symptoms:

  • Anxiety
  • Emotional lability and/or depression
  • Irritability, aggression and/or severely oppositional behaviors
  • Behavioral (developmental) regression
  • Deterioration in school performance
  • Sensory or motor abnormalities
  • somatic signs including sleep disturbances, enuresis or urinary frequency


The onset of PANS may start with infectious agents other than strep.  It also includes onset from environmental triggers or immune dysfunction.


PANDAS is defined by the following criteria:

The clinical diagnosis of PANDAS includes 5 criteria:

  • Presence of significant obsession, compulsions and/or tics
  • Abrupt onset of symptoms or a relapsing-remitting course of symptom severity
  • Prepubertal onset
  • Association with streptococcal infection
  • Association with other neuropsychiatrc symptoms (includes any of the PANS “accompanying” symptoms).


Other symptoms can include:

  • Obsessions/preoccupations
  • Fixed ideas and thoughts/unwanted feelings
  • Separation anxiety
  • ADHD
  • Mood changes (irritability, sadness, emotional liability)
  • Sleep disturbance
  • Night-time bed weting and/or day –time urinary frequency
  • Fine/gross motor changes (e.g. changes in handwriting)
  • Joint Pains.
  • Motor and/or vocal tics
  • General anxiety
  • Oppostitional defiance
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