PANDAS Syndrome: Symptoms, Causes, and Treatment Options

Written by Medicover Team and Medically Reviewed by Dr Udaya Keerthi Kanna , Pediatrician

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Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a neurological and behavioral condition in children caused by an autoimmune reaction following a streptococcal infection.

It affects the brain, particularly the basal ganglia, and leads to the sudden onset of obsessive-compulsive behaviors and movement-related disorders.

What are the PANDAS Syndrome Symptoms and Warning Signs?

The symptoms of PANDAS Syndrome can be both sudden and severe. They often appear abruptly, usually within days or weeks following a strep infection. Key symptoms include:

Common Symptoms

• Sudden onset of obsessive-compulsive behaviors (OCD)
• Motor or vocal tics (eye blinking, facial twitching, throat clearing)
• Anxiety, particularly separation anxiety
• Mood swings and emotional instability

Severe Symptoms

• Aggressive or defiant behavior
• Sleep disturbances and nightmares
• Frequent urination without infection
• Food restriction or eating disorders
• Decline in academic performance or memory

Consult a pediatrician promptly if these symptoms appear suddenly after a sore throat or fever.

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What are the Common Causes and Risk Factors of PANDAS Syndrome?

PANDAS is primarily caused by an abnormal immune response following a streptococcal infection.

Causes

• Group A Streptococcus (GAS) infections like strep throat or scarlet fever
• Autoimmune reaction targeting brain tissue

Risk Factors

• Age: Most commonly affects children between 3 and 12 years
• Gender: Boys may be at slightly higher risk
• Frequent strep infections
• Family history of autoimmune or neuropsychiatric disorders

Early diagnosis is essential to manage symptoms and prevent worsening.

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How is PANDAS Syndrome Diagnosed?

Diagnosing PANDAS requires a thorough medical history, a physical examination, and specific diagnostic tests.

Diagnosis is based on

• Sudden onset of OCD or tics after a strep infection
• Recent history of Group A Streptococcal infection
• Neurological abnormalities like involuntary movements

Diagnostic Tests

• Throat swab or rapid strep test
• Anti-streptolysin O (ASO) and Anti-DNase B blood tests
• Neurological assessment
• Neuroimaging (rarely used)

At Medicover, our pediatric neurologists and infectious disease experts collaborate to deliver precise, evidence-based diagnoses using advanced testing methods.

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What are the Treatment Options for PANDAS Syndrome?

Effective treatment of PANDAS often requires a multifaceted approach that addresses both the underlying infection and the neuropsychiatric symptoms.

Antibiotics

• Penicillin, amoxicillin, or azithromycin are used to treat strep infections.

Immunomodulatory Therapy

• Corticosteroids to reduce inflammation
• Intravenous immunoglobulin (IVIG) to modulate immune response
• Plasmapheresis for severe, resistant cases

Psychiatric and Behavioral Therapies

• Cognitive Behavioral Therapy (CBT)
• Exposure and Response Prevention (ERP)
• Family Counseling

Supportive Treatments

• Occupational or speech therapy
• School accommodations

At Medicover, we combine clinical expertise with compassionate care to tailor each child's treatment plan for optimal recovery and support.

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When to See a Doctor?

See a doctor immediately if:

• Your child shows sudden OCD symptoms or tics following a strep infection
• Symptoms are severe or disrupt daily life
• Your child experiences persistent anxiety or sleep issues

High-risk children with repeated strep infections or family history of autoimmune diseases should be monitored closely.

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What is the Recovery Process After PANDAS Syndrome Treatment?

Recovery varies by child and treatment response.

• Regular follow-up visits with pediatricians or neurologists
• Continued behavioral therapy
• Immune system monitoring in recurrent cases
• Nutritional support and consistent routines help healing

At Medicover, we offer complete post-treatment support through regular follow-ups, individual educational plans, and caregiver guidance to ensure a holistic recovery.

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What Precautions Can Help Prevent PANDAS Syndrome?

Prevention

• Prompt treatment of strep infections
• Good hygiene to reduce infection spread
• Regular check-ups for children prone to frequent infections

Complications if Untreated

• Worsening of OCD and tic symptoms
• Long-term behavioral and academic challenges
• Risk of repeated autoimmune flares

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Our Experience Treating PANDAS Syndrome

At Medicover, we care deeply about children facing PANDAS Syndrome. With expert pediatricians, psychologists, and neurologists working together, we provide individual care that addresses both the infection and its emotional impact, supporting families every step of the way.

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