PANS and PANDAS are infection-triggered autoimmune disorders affecting the basal ganglia, which can result in a multitude of neuropsychiatric symptoms including OCD-like behaviors, tics and/or restrictive eating in children and adolescents.

PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections) are a type of autoimmune disorder that results in basal ganglia encephalitis and are believed to be triggered primarily by infections. These disorders are characterized by the sudden onset of neurologic and psychiatric symptoms preceded by an infection(s).
Similar to other types of autoimmune encephalitis syndromes, PANS and PANDAS occur when antibodies, produced by an individual’s own immune system in response to an infection or insult, mistakenly attack healthy tissue in the brain.

Autoimmune basal ganglia encephalitis

PANS and PANDAS have similar symptom presentations and respond to similar treatment regimes. PANS is a broader syndrome that includes PANDAS. While PANDAS is a disorder categorized by strep infections, PANS may be caused by various infectious agents other than just strep (or the etiology may be unknown) and may even result from non-infectious triggers.

Infections that have been reported in patients with PANS include: influenza, Epstein Barr virus (EBV), mycoplasma pneumonia, herpes simplex virus (HSV), varicella, upper respiratory infections (including rhinosinusitis, pharyngitis, or bronchitis), and Borrelia burgdorferi (Lyme disease).¹ Other infections that have been identified in patients with PANS include: babesia, bartonella, coxsackie virus.

In PANS and PANDAS, autoantibodies target healthy proteins or receptors in the brain, principally in the basal ganglia, a region of the brain responsible for motor movements, learning, cognition, and emotion.

These autoimmune antibodies bind to or block certain biological components in the basal ganglia, resulting in brain inflammation (encephalitis) and disruption of normal neuronal functioning. This, in turn, can manifest in the onset of psychiatric and/or neurologic symptoms.


PANS can occur at any age. However, symptoms often begin during grade-school years. Patients can also have their initial symptom onset during adolescence. PANDAS criteria requires that symptom onset occur between 3 years of age and puberty. 2

Symptoms vary from person to person, range in severity and typically follow a relapsing-remitting course. Several symptoms are often present simultaneously. 2

PANS and PANDAS can be misdiagnosed as psychiatric illness

PANS and PANDAS symptoms may include obsessive-compulsive behaviors, motor/vocal tics, restrictive eating, emotional lability, ADHD-like behaviors (i.e., irritability, impulsivity), aggression, bursts of rage, anxiety, depression, oppositional behaviors, behavioral regression, motor and sensory abnormalities, sleep disturbances, decline in school performance, enuresis or urinary frequency.

Patients with PANS and PANDAS may be misdiagnosed with a psychiatric illness or behavioral disorder, when the symptoms may be the result of a treatable autoimmune dysfunction.

Identifying PANS/PANDAS is important, as studies indicate that with proper anti-infective and/or immunomodulatory treatment, symptoms can resolve or be dramatically reduced. 3

PANS and PANDAS are clinical diagnoses based on a patient’s symptoms, family history, and laboratory results. “It should be noted that PANS is a ‘diagnosis of exclusion’ and that other known medical diseases must be ruled out before a diagnosis of PANS is assigned.” 1

Testing with the Cunningham Panel™

The Cunningham Panel™ can support a clinician’s diagnosis with laboratory evidence and assist in determining an appropriate treatment regimen.

The Panel measures the levels of circulating autoantibodies associated with specific neuropsychiatric symptoms reported in PANS and PANDAS, along with the ability of these autoantibodies to stimulate an enzyme responsible for upregulating neurotransmitters in the brain.

The Cunningham Panel™ identifies the presence of elevated autoantibodies against brain proteins and neurologic targets, which indicate that a patient’s psychiatric and/or neurologic symptoms may be due to an infection-induced autoimmune basal ganglia encephalitis, such as PANS and PANDAS.

  1. Kiki Chang, Jennifer Frankovich, Michael Cooperstock, Madeleine W. Cunningham, M. Elizabeth Latimer, Tanya K. Murphy, Mark Pasternack, Margo Thienemann, Kyle Williams, Jolan Walter, Susan E. Swedo, and From the PANS Collaborative Consortium.  (2015). "Clinical evaluation of youth with pediatric acute-onset neuropsychiatric syndrome (PANS): recommendations from the 2013 PANS Consensus Conference." J Child Adolesc Psychopharmacol 25(1): 3-13.
  2. PANDAS Physicians Network (PPN).
  3. Jennifer Frankovich, Susan Swedo, Tanya Murphy, Russell C. Dale, Dritan Agalliu, Kyle Williams, Michael Daines, Mady Hornig, Harry Chugani, Terence Sanger, Eyal Muscal, Mark Pasternack, Michael Cooperstock, Hayley Gans, Yujuan Zhang, Madeleine Cunningham, Gail Bernstein, Reuven Bromberg, Theresa Willett, Kayla Brown, Bahare Farhadian, Kiki Chang, Daniel Geller, Joseph Hernandez, Janell Sherr, Richard Shaw, Elizabeth Latimer, James Leckman, Margo Thienemann, and PANS/PANDAS Consortium. (2017). "Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part II—Use of Immunomodulatory Therapies." J Child Adolesc Psychopharmacol 27: 1-16.
Group A Strep and other infections can trigger an autoimmune response directed against the brain in PANS and PANDAS

Group A Strep and other infections can trigger an autoimmune response directed against the brain, resulting in the onset of multiple neuropsychiatric symptoms.

Read What Is Pans?
Read What Is Pandas?
Read Patient Stories
Read Physician Testimonials about the Cunningham Panel


How Can Infection Cause PANS/PANDAS

How Can An Infection Cause PANS/PANDAS

Recognizing Neuropsychiatric Symptoms

Recognizing Auto-immune Induced Neuropsychiatric Symptoms

Watch Cunningham Panel Video

Watch Cunningham Panel Video

  • Test Order Process
    The Cunningham Panel™ – Antibody testing that helps determine whether an autoimmune response may be triggering neurologic and/or psychiatric symptoms.

B. Robert Mozayeni, MD

Medical and Clinical Advisor

B. Robert Mozayeni MD

Dr. B. Robert Mozayeni was trained in Internal Medicine and Rheumatology at Yale and at NIH. He has had pre- and post-doctoral Fellowships in Molecular Biophysics and Biochemistry at Yale, and also at NIH where he was a Howard Hughes Research Scholar at LMB/DCBD/NCI and later, Senior Staff Fellow at LMMB/NHLBI/NIH. Editorial board of Infectious Diseases – Surveillance, Prevention and Treatment. Past President of the International Lyme and Associated Diseases Society (ILADS).

He is an expert in Translational Medicine, the science and art of advancing medical science safely and efficiently. He is a Fellow of the non-profit Think Lead Innovate Foundation and is a co-founder of the Foundation for the Study of Inflammatory Diseases. He is a Founder of the Foundation for the Study of Inflammatory Diseases to crowd-source medical solutions for complex conditions using existing knowledge, diagnostic methods, and therapies to meet patient needs immediately. He is the Chief Medical Officer of Galaxy Diagnostics, LLC. He is a Board member of the Human-Kind Alliance. Dr. Mozayeni has held admitting privileges (since 1994) on the clinical staff of Suburban Hospital, a member of Johns Hopkins Medicine and an affiliate of the National Institutes of Health Clinical Center.

Safedin Sajo Beqaj, PhD, HCLD, CC (ABB)

Moleculera Labs, Clinical Laboratory Advisor
Medical Database, Inc., President and CEO

Sajo Baqaj, PhD

Dr. Sajo Beqaj is board certified in molecular pathology and genetics and licensed as a Bioanalyst and High Complexity Laboratory Director. He has been practicing as a laboratory director since 2005.

Dr. Beqaj served as a technical director and was part of the initial management team for several well-known laboratories in the clinical lab industry including PathGroup, Nashville, TN; DCL Medical Laboratories, Indianapolis, IN, and Pathology, Inc, Torrance, CA. He is currently serving as off-side CLIA laboratory director for BioCorp Clinical Laboratory, Whittier, CA and Health360 Labs, Garden Grove, CA.

Dr. Beqaj received his Ph.D. in Pathology from Wayne State University Medical School, Detroit, Michigan. He performed his post-doctoral fellowship at Abbott Laboratories from 2001-2003 and with Children’s Hospital and Northwestern University from 2003-2005.

Dr. Beqaj has taught in several academic institutions and has published numerous medical textbook chapters and journal articles. He has served as a principal investigator in clinical trials for several well-known pharmaceutical and diagnostic companies such as Roche HPV Athena, Merck HPV vaccine, BD vaginitis panel, Roche (Vantana) CINtec® Histology clinical trials, and has presented various scientific clinical abstracts and presentations.

He is a member of several medical and scientific associations including the Association of Molecular Pathology, American Association of Clinical Chemistry and the Pan Am Society for Clinical Virology. He has served on a number of clinical laboratory regulatory and scientific committees, and has assisted several laboratories and physicians as a Clinical Laboratory Consultant.

Rodney Cotton, MBA

Moleculera Labs Board Member

Rodney Cotton, MBA

Rodney Cotton, MBA is an entrepreneurial thought leader in the pharmaceutical/biotech industry who is known for his holistic perspective, bias for action in the face of challenges, and commitment to agile processes.

Rod is an independent director for Orchard Software, a private equity-backed health technology company owned by Francisco Partners; an advisory board member to Flo2 Ventures, a venture capital-backed healthcare and health equity accelerator; and a member of the board of directors and three board committees (Audit, Compliance & Finance; Governance & Equity; and Quality of Care) for Community Health Network.

He built a successful career at Roche spanning more than two decades and culminating in the role of SVP, Head of Strategy & Transformation, and Chief of Staff to the CEO for Roche Diagnostics, the North American headquarters of the world’s largest ($17B) diagnostics company.

While at Roche, Rod led key enterprise initiatives, such as milestone corporate communications, health equity coalitions, the US/Roche Group audit, and global/US acquisition integrations. With 40+ years of experience, he drove the financial turnaround and cultural transformation of four global healthcare companies, led teams of up to 280 total reports, managed P&L of more than $1 billion, and served as a key member of the senior leadership team executing the most significant restructuring of the company in two decades.

In the face of the COVID-19 pandemic, Rod and his team at Roche accelerated six ground breaking products in 11 months, including the first launch of the market’s most accurate and in demand molecular diagnostic test. He also solved extraordinary challenges of product scarcity, supply chain, product allocation, and logistics to achieve accelerated global sourcing and self manufacturing in line with testing guidelines.

A frequent public speaker on health equity and other topics, Rod was named one of the Most Influential Black Executives in Corporate America by Savoy Magazine and one of the Top Blacks in Healthcare by He also received The Sagamore of the Wabash Award, one of the highest Indiana State honors, bestowed by Indiana Governor Eric J. Holcomb.

Rod holds an M.B.A. from California State University, Dominguez Hills, an M.S. in Strategic Management from the University of Southern California, and a B.A. in Biological Sciences & Technology from the University of California at Santa Barbara.