PANDAS is a clinical diagnosis based on 5 distinct criteria as developed by the NIMH and listed below. Currently there are no definitive diagnostic laboratory tests for PANDAS, but the Cunningham Panel™ is the first and only test that was developed specifically as an aid to doctors in making their diagnosis.
This test panel, which includes 5 assays, identifies a patient’s specific antibody levels directed against certain neurologic proteins and the antibody’s capability of triggering and stimulating elevated neurotransmitter production in brain cells.
Guidelines For Diagnosing PANDAS
The National Institute of Mental Health has introduced guidelines for diagnosing PANDAS. These criteria include:
- Presence of clinically significant obsessions, compulsions and/or tics
- Unusually abrupt onset of symptoms or a relapsing-remitting course of symptom severity
- Pre-pubertal onset. Symptoms of the disorder first become evident between 3 years of age and puberty
- Association with Group A Streptococcal (GAS) infection. Note: In PANDAS, GAS infections may be present without apparent pharyngitis (i.e., no complaints of a sore throat)
- Association with other neuropsychiatric symptoms
Common PANDAS Symptoms
The most common accompanying symptoms listed by the NIMH include:
- Severe separation anxiety
- Generalized anxiety
- Motoric hyperactivity, abnormal movements, and a sense of restlessness
- Sensory abnormalities (sensitivity to light or sounds), distortions of visual perceptions, and occasionally, visual or auditory hallucinations
- Difficulties concentrating, and loss of academic abilities, particularly in math and visual-spatial areas
- Increased urinary frequency, or sense of urgency and/or a new onset of bed-wetting
- Irritability (sometimes with aggression) and emotional lability. Abrupt onset of depression can also occur, with thoughts about suicide
- Developmental regression, including temper tantrums, “baby talk” and handwriting deterioration
- Parents can usually remember the day their child’s behavior changed. PANS and PANDAS is characterized by an abrupt onset of obsessive-compulsive disorders and/or tics
A detailed review of the diagnostic guidelines for PANS and PANDAS is available on the PANDAS Physicians Network.