Pediatric acute-onset neuropsychiatric syndrome

Pediatric acute-onset neuropsychiatric syndrome (PANS)[1] is a clinically defined disorder characterized by the sudden onset of obsessive-compulsive symptoms or eating restrictions, concomitant with acute behavioral deterioration and/or motor/sensory changes in at least two of seven domains.[1] Those domains are anxiety, emotional lability and/or depression, irritability, aggressive or oppositional behavior, academic decline, cognitive decline, and sleep disruption.[1] The definitive diagnosis also necessitates a course that follows a relapsing–remitting pattern. In the case of post-puberty chronicity residual symptoms and their severity increases.[2]

Pediatric acute-onset neuropsychiatric syndrome
SpecialtyNeuroimmunology

Diagnosis

PANS is an exclusively clinical diagnosis based on the exclusion of other disorders (exclusion diagnostics) and is characterized by symptoms typical of basal ganglia dysfunction and the results of altered functions of the inert part of the immune system. PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) is basically PANS caused by streptococcal infection and has symptoms similar (but not equal) to PANS. However, the pathological mechanisms of PANDAS are still under research.[3] Possible laboratory markers for PANDAS have been discussed and tested, with no promising results. PANS and PANDAS are, despite their similarity, not interchangeable concepts and terms.

PANS/PANDAS Research Consortium

A consortium of academic clinicians and scientists was convened in 2013 to develop more defined diagnostic guidelines for this disorder in anticipation of furthering research, clinical trials, and clinical care for this patient subgroup.[1]

References
  1. Chang K, Frankovich J, Cooperstock M, et al. (February 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. doi:10.1089/cap.2014.0084. PMC 4340805. PMID 25325534.
  2. Swedo SE, Frankovich J, Murphy TK (September 2017). "Overview of Treatment of Pediatric Acute-Onset Neuropsychiatric Syndrome". J Child Adolesc Psychopharmacol. 27 (7): 562–565. doi:10.1089/cap.2017.0042. PMC 5610386. PMID 28722464.
  3. Thienemann M, Murphy T, Leckman J, et al. (September 2017). "Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part I-Psychiatric and Behavioral Interventions". J Child Adolesc Psychopharmacol (Review). 27 (7): 566–573. doi:10.1089/cap.2016.0145. PMC 5610394. PMID 28722481.
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