Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) and Pediatric Acute-Onset of Neuropsychiatric Syndrome (PANS) are disorders related to rapid changes in behavior of a child or young adult.

PANDAS is associated with Group A beta-hemolytic strep infections while PANS can be activated due to other infectious causes, including Tick-borne infections. Other neurotoxins such as repeated mold exposure and heavy metals also play a role. Symptoms arise from inflammatory triggers in the brain, which change behavior. If left untreated this can change the trajectory of a child’s life dramatically, causing unnecessary trauma for the children and their families.

Common symptoms are obsessive compulsive disorder, tics, depression, aggression, changes in school performance, sensory or motor difficulties, sleep disturbances, anxiety, anorexia, hyperactivity and wetting the bed. These symptoms can flare depending on the time of year, level of stress, and exposure to infections/toxins. This can be very difficult situation for a families to go through, as they try to find acknowledgement of the condition. Children are often misunderstood and misdiagnosed with mental illness.

The underlying infection needs to be treated to reduce or eliminate symptoms to improve the child’s quality of life.

Diagnosing PANDAS and PANS


PANDAS is diagnosed with confirmation of Group A streptococcal bacteria (the cause of strep throat and scarlet fever). This can be done with a throat swab and/or a blood test with elevated antistreptococcal titers (ASO and anti-DNase).

Rapid strep tests can be inconclusive. Strep causing PANDAS is often “silent” and produces few or no symptoms of a sore throat. There may also be seasonal re-activation of neuropsychiatric symptoms in children if there is exposure in school or at home to others who are sick with Strep infections. 


As a clinical syndrome, Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is a diagnosis based on the signs, symptoms, and medical history of the patient rather than on laboratory tests or medical imaging. This does not determine the cause of the symptoms, nor does it determine an appropriate course of treatment. Testing and in-depth history with physical helps to rule out other causes. In our experience there are typically other infections or toxicity that is related to the symptoms.

We commonly test for other infections such as Tick-borne disease, Mycoplasma pneumonia, Mold Biotoxin Illness, inflammation in the digestive tract and any other stressors impacting the neuropsychiatric imbalance. There are specialty labs such as the Cunningham Panel and Neuro-Zoomer which evaluates level of neuroinflammation.

The symptoms are usually dramatic, happening overnight.

Symptoms and Treatment for PANDAS/PANS

Common Symptoms

  • Obsessive, compulsive, and repetitive behaviors.
  • Separation anxiety, fear, and panic attacks.
  • Incessant screaming, irritability, and frequent mood changes.
  • Emotional and developmental regression.
  • Visual or auditory hallucinations.
  • Depression and suicidal thoughts.



Typically, this is accomplished with a combination of antibiotic therapy and natural medication support. Natural medication support assists in reducing inflammation, improving integrity of the digestive tract, eliminating toxins, reducing impact of symptom flares, and resolving infection. 

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