Pediatric acute-onset neuropsychiatric syndrome

Psychiatr Clin North Am. 2014 Sep;37(3):353-74. doi: 10.1016/j.psc.2014.06.001.


Whether some instances of obsessive-compulsive disorder are secondary to infectious and/or autoimmune processes is still under scientific debate. The nosology has undergone an iterative process of criteria and acronyms from PITANDS to PANDAS to PANS (or CANS for neurology). This review focuses on the clinical presentation, assessment, proposed pathophysiology, and treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcus (PANDAS), and the newest iteration, pediatric acute-onset neuropsychiatric syndrome (PANS). Children who have these symptoms, which have become known as PANS, have been described by their parents as "changed children."

Keywords: PANDAS; Pediatric autoimmune neuropsychiatric disorder; Streptococcal infections.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Autoimmune Diseases* / diagnosis
  • Autoimmune Diseases* / drug therapy
  • Autoimmune Diseases* / physiopathology
  • Autoimmune Diseases* / surgery
  • Autoimmune Diseases* / therapy
  • Combined Modality Therapy
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Obsessive-Compulsive Disorder / diagnosis*
  • Plasma Exchange
  • Risk Factors
  • Streptococcal Infections* / diagnosis
  • Streptococcal Infections* / drug therapy
  • Streptococcal Infections* / physiopathology
  • Streptococcal Infections* / surgery
  • Streptococcal Infections* / therapy
  • Tonsillectomy


  • Anti-Bacterial Agents
  • Immunoglobulins, Intravenous

Supplementary concepts

  • Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections