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    PANDAS

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    PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) causes abrupt behavioral and neurological changes in children after streptococcal infections.

    What is PANDAS?

    PANDAS is a condition in which children experience a sudden, dramatic onset of obsessive-compulsive disorder (OCD), tic disorders, severe anxiety, emotional lability, irritability, and sometimes regression in handwriting, math skills, or motor function following a Group A streptococcal (strep) infection. The theory is that the immune system's antibodies, produced to fight the strep infection, mistakenly attack a part of the brain called the basal ganglia, causing neuropsychiatric symptoms. PANDAS is diagnosed based on specific clinical criteria including pre-pubertal onset, association with Group A strep, acute severity and episodic course, and neurological abnormalities during flares. Treatment may include antibiotics to clear the underlying infection, immunomodulatory therapies (IVIG, plasmapheresis) for severe cases, and cognitive-behavioral therapy for OCD and anxiety symptoms. Early recognition and treatment are critical for preventing long-term neuropsychiatric effects.

    Common Signs & Symptoms

    Sudden onset of OCD symptoms
    Tics or Tourette-like movements
    Severe separation anxiety
    Emotional lability and irritability
    Regression in handwriting or math skills
    Urinary frequency or bedwetting
    Sleep disturbances
    Restricted food intake
    Joint pain

    Ways to Cope & Manage

    Antibiotic Treatment

    Prompt treatment of strep infections with antibiotics to reduce the autoimmune trigger and prevent symptom flares.

    Immunomodulatory Therapy

    IVIG (intravenous immunoglobulin) or plasmapheresis for severe cases to reduce the autoimmune attack on the brain.

    Cognitive-Behavioral Therapy

    CBT, particularly Exposure and Response Prevention (ERP), to help children manage OCD symptoms and anxiety.

    Anti-Inflammatory Support

    NSAIDs or corticosteroids may be used during flares to reduce brain inflammation and symptom severity.

    School Accommodations

    IEP or 504 plan modifications during flares including reduced workload, extra time, and behavioral support.

    If you or someone you know is in crisis, call the 988 Suicide & Crisis Lifeline — dial or text 988

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