PANS describes a group of symptoms, such as obsessive-compulsive behavior and severe eating changes, that develop suddenly in children. Not all healthcare providers accept PANS as an official condition. But getting medical help for your child’s symptoms is important.
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PANS (pediatric acute-onset neuropsychiatric syndrome) is a group of symptoms, like eating changes and obsessive-compulsive behavior, that may develop suddenly in children. Some researchers think infections or other environmental factors cause the syndrome.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Overall, PANS seems to be rare. It’s an overlapping syndrome with PANDAS. They have the same symptoms. But PANDAS is specifically associated with strep infections.
Researchers continue to study this syndrome. For some experts, PANS is controversial as a medical diagnosis because it:
Sudden changes in your child’s behavior are concerning. These symptoms are real, and healthcare providers take them seriously. Symptoms can have many causes. But sometimes, no one knows the cause.
Providers may not agree on all aspects of PANS. But what’s most important is that they can guide the most helpful treatment for your child, no matter the diagnosis.
The main feature of PANS is a sudden onset of obsessive-compulsive behaviors and/or eating restrictions. These symptoms start overnight or within a few days. They may then come and go in episodes.
Children thought to have this condition also have at least two of the following sudden symptoms:
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Researchers haven’t found a clear cause of PANS. The main theory is that it’s an autoimmune condition.
Some researchers think it happens when your child’s immune system mistakenly attacks their brain and/or spinal cord. An infection or other environmental factors, like emotional stress or exposure to oxidative toxins, may trigger this response. And long-term inflammation may make the symptoms last.
Examples of infections thought to trigger PANS include:
Some researchers think children may be at a higher risk of PANS if they have:
Without treatment, symptoms like obsessive-compulsive behaviors and eating restrictions may get worse. They may last into adulthood. Talk therapies and medications can help your child manage these conditions.
Healthcare providers vary in how they approach PANS. There isn’t a specific test to diagnose it. But it’s important to get help for your child’s symptoms.
A provider will do a physical exam and ask about changes in your child. Much of the diagnostic process involves ruling out other possible causes of the symptoms. To do this, your child’s provider may recommend certain lab tests and/or brain imaging tests.
It may be helpful to see medical specialists, like pediatric psychiatrists and neurologists.
The proposed diagnostic criteria for PANS include:
This diagnosis doesn’t require a known trigger.
There aren’t any treatments for PANS approved by the U.S. Food and Drug Administration (FDA). Regardless of the underlying cause, the goal is to manage symptoms. Certain therapies can help with OCD symptoms and restricted eating, like:
Researchers are studying other possible treatments. Your child may be able to join a clinical trial involving one of these therapies:
OCD, behavioral challenges and eating restrictions can affect how your child functions day to day. Because of that, it may help to focus on treating each symptom they have. Several studies show that talk therapies can decrease the frequency and severity of these symptoms. Psychiatric medication may also help.
Take care of yourself, too. Sudden changes in your child can be emotionally draining. You may feel like you’re caring for a child you don’t know. And it can be frustrating not to feel heard. If you’re getting overwhelmed, seek help from a mental health provider.
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When your child’s behavior changes suddenly, it’s natural to want to understand it and fix it as soon as possible. You want the best for those you love the most. But some diagnoses and treatments are complex, especially when it comes to symptoms related to brain differences.
Medical experts can be your guide. They’ll do thorough evaluations to get to the bottom of your child’s PANS symptoms. It may take time, but getting an accurate diagnosis leads to the most effective treatment. Don’t hesitate to ask questions along the way. You know your child better than anyone else.
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Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.
Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.
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