PANS and PANDAS are clinical diagnosis and based on whether presenting symptoms meet the diagnostic criteria, as set forth by National Institute of Mental Health (NIMH). Recognizing PANS/PANDAS can be challenging even for the most skilled clinicians. Far too often, children and adolescents are misdiagnosed as having a mental illness, when in fact, they have an autoimmune disease, triggered by an infection.
Cunningham Panel™ Assists Clinicians in the Diagnosis of PANS and PANDAS
The Cunningham Panel of tests can assist clinicians in making the correct diagnosis. The Panel provides insight into how a child’s immune system is functioning. Specifically, the test measures the levels of certain autoantibodies (responsible for causing the symptoms) circulating in a child’s bloodstream. The higher the levels, the greater the likelihood that the patient’s psychiatric and neurologic behaviors are due to an infection.
These treatable autoimmune neurologic conditions share many similarities in symptom presentation but the diagnostic criteria and the etiology behind each differs. PANDAS is triggered by a Strep infection, while PANS is caused by exposure to a range of infections, including the flu, sinusitis, mycoplasma pneumonia, and Lyme disease.
Characteristics of PANS and PANDAS
PANDAS is characterized by a sudden and dramatic onset of OCD and/or tics following a Strep infection in pre-pubescent children. To meet the diagnostic criteria, a patient must also exhibit neurological abnormalities (motoric hyperactivity or choreiform movements). Although not part of the criteria, the presence of co-morbid neuropsychiatric symptoms is universal in children with PANDAS. PANDAS Diagnostic Criteria
The hallmark traits of PANS includes an abrupt onset of OCD or severely restricted food intake, in conjunction with the acute onset of several neuropsychiatric symptoms described in the NIMH criteria. There is no age criteria for PANS, however most patients have an onset of illness during their school-aged years. PANS Diagnostic Criteria
Treatment of PANS and PANDAS
Since PANS and PANDAS are autoimmune syndromes, it’s imperative to treat not only the underlying infection(s) but the immune dysfunction as well. Treatment can include antibiotics, immune modulating therapies, such as Intravenous immunoglobulin (IVIG), plasmapheresis and steroids. Anti-inflammatories, anti-histamines, SSRI’s and Cognitive Behavior Therapy are also used in managing symptoms.
We encourage you to visit the PANDAS Physician’s Network to view specific diagnostic criteria and treatment options.