Symptoms of PANDAS and PANS

Feature PANDAS PANS
Trigger Streptococcal Infection Any Infection or Environmental Trigger
Onset Sudden, Dramatic Sudden, Dramatic
Core Symptoms OCD, Tics, Anxiety OCD, Anxiety, Eating restrictions, Cognitive decline
Treatment Focus Strep-related imune response Broader Infection & Immune triggers

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What Makes These Symptoms Different?

While many children experience anxiety, tics, or behavioral challenges at some point, the hallmark of PANDAS and PANS is the sudden, overnight onset of multiple symptoms that are severe and disruptive. Parents often describe their child as seeming “like a different person” almost instantly.

When to Seek Help

If your child suddenly develops multiple symptoms — especially after a recent infection — it’s important to seek medical evaluation. Early recognition and intervention can significantly improve outcomes.

Testing & Diagnosis
Strep Infection

Understanding PANDAS & PANS

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) are conditions where a child’s immune system mistakenly attacks parts of the brain. This often happens after an infection, causing sudden and dramatic changes in mood, behavior, and physical health.

Recognizing symptoms early is the first step toward getting your child the support and treatment they need.

FAQs

How quickly do symptoms appear?

Most parents report symptoms begin within 24–48 hours, often following an infection.

Can these symptoms look like ADHD, autism, or typical anxiety?

Yes. PANDAS/PANS symptoms often overlap with other conditions, which can make diagnosis challenging. The key difference is the sudden, dramatic onset.

Does my child need to have tics to have PANDAS/PANS?

No. Some children develop tics, others show more OCD, anxiety, or eating changes.

Key Symptoms at a Glance

Children with PANDAS or PANS typically experience a sudden onset of symptoms — often appearing within 24 to 48 hours.

1. Sudden OCD or Severe Anxiety

  • Intense fears or phobias

  • Compulsive behaviors or rituals

  • Fear of germs, contamination, or harm

2. Motor & Vocal Tics

  • Repetitive movements (eye blinking, shoulder shrugging, jerking)

  • Sudden sounds (throat clearing, grunting, squeaking)

3. Mood and Behavior Changes

  • Rage episodes and aggression

  • Irritability and mood swings

  • Sudden depression or withdrawal

  • Separation anxiety

4. Eating Disturbances

  • Sudden refusal to eat

  • Fear of choking or vomiting

  • Extreme food restriction or weight loss

5. Cognitive and Learning Challenges

  • Sharp drop in school performance

  • Trouble with focus and attention

  • Memory problems

  • Handwriting deterioration (sudden messy or small writing)

6. Physical Symptoms

  • Sleep problems or insomnia

  • Bedwetting or frequent urination

  • Sensory sensitivities (sound, light, touch)

  • Joint pain, headaches, or fatigue

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