Pediatric Acute-onset Neuropsychiatric Syndrome

Pediatric Acute-onset Neuropsychiatric Syndrome is a neuropsychiatric syndrome. It consists of many different symptoms.

Pediatric Acute-onset Neuropsychiatric Syndrome

What is Pediatric Acute-onset Neuropsychiatric Syndrome?

The pediatric acute-onset neuropsychiatric syndrome is also known as PANS for short. What is meant by this is a neuropsychiatric disorder that begins suddenly. It first appears in childhood or adolescence. It is characterized by compulsive behavioral problems and thought disorders. See foodanddrinkjournal for HI Dictionary Definitions.

Tics and physical-neurological abnormalities are also features of the syndrome. Pediatric Acute-onset Neuropsychiatric Syndrome was discovered during PANDAS research, which looked at the neuropsychiatric syndrome Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS).

The research took place at the US NIMH Institute in Bethesda (Maryland). NIMH stands for “National Institute for Mental Health” and is the world’s largest institute for research into mental illnesses. It is a sub-agency of the US Department of Health and Human Services. Research into PANS is still ongoing and focuses on the development, treatment and prognosis of the syndrome.


So far it has not been possible to elucidate the exact pathophysiological causes of the pediatric acute-onset neuropsychiatric syndrome. In some cases, PANS is suspected to be the result of viral or bacterial infections. Suspicious bacteria include mycoplasma, streptococci and borrelia. However, genetic changes or metabolic disorders are also suspected of being responsible for PANS.

Changes in metabolic products such as kynorenine and inflammatory markers such as TNF-╬▒ and neopterin have been described. Some scientists assume that certain brain structures are affected by immunological processes. This is especially true in the region of the basal ganglia.

Researchers consider the neurological disease chorea minor to be a prototypical pathogenic mechanism. In pediatric acute-onset neuropsychiatric syndrome, however, the psychiatric symptoms are dominant. The syndrome is responsible for thought disorders, obsessive-compulsive symptoms, motor disorders and behavioral changes. In addition, PANS can also be the trigger of tics and obsessive -compulsive disorders in adults.

Symptoms, Ailments & Signs

It is typical of the pediatric acute-onset neuropsychiatric syndrome that the symptoms appear abruptly in children and adolescents. The symptoms correspond to a basal ganglia dysfunction. In addition, many different complaints can appear. These include aggression, rebellious behavior, irritability, anxiety, depression, behavioral regression, and deterioration in academic or professional performance.

Furthermore, there can be sleep problems in which the REM sleep or day-night rhythm is disturbed. There are also motor or sensory abnormalities, which include, for example, a deterioration in handwriting. Sometimes there are somatic symptoms such as bedwetting (enuresis) and a change in the frequency of urination.

Furthermore, neurological-psychiatric abnormalities such as memory disorders, cognitive deficits or separation anxiety are possible. It is not uncommon for patients to suffer from tics or obsessive thoughts and refuse to eat.

Diagnosis & course of disease

If a pediatric acute-onset neuropsychiatric syndrome is suspected, a medical examination is necessary. Doctors make the diagnosis based on the symptoms associated with PANS. Tics, thought disorders, compulsive behavior and the refusal to eat are considered characteristic. In addition, the disease must occur in a child or adolescent.

Another criterion is a recent infection. Furthermore, the symptoms progress in phases. To confirm the suspicion of PANS, at least two of the cardinal symptoms must be present in the patient. Another diagnostic criterion is the fact that the symptoms cannot be explained by other diseases such as Tourette’s syndrome, minor chorea or lupus erythematosus.

In adults, there is a structurally analogous syndrome called PIBS (Post-inflammatory Brain Syndrome). Basically, the diagnostic criteria of PANS and PANDAS are very similar. However, pediatric acute-onset neuropsychiatric syndrome does not necessarily result from streptococcal infection.

PANS usually manifests itself in children and adolescents. The disease can persist into adulthood. While some cases take an acute course, chronicity must be expected in most patients. PANS then persists throughout life in varying degrees of severity.


Patients with this disease suffer from a number of different ailments. As a rule, the patients appear aggressive and permanently irritated. Since the disease occurs in children and adolescents, it can lead to serious social problems and problems in the child’s development. Depression and other mental upsets also often occur.

The patients themselves suffer from confusion and often from anxiety. The professional or school performance can also suffer from this disease. Furthermore, the patients often still suffer from serious psychological complaints in adulthood. Due to the sleep disorders, the aggressive behavior is usually additionally favored. Bedwetting in adolescence can also occur.

The disease also leads to memory disorders or eating disorders. Parents and relatives often suffer from psychological problems or depression as a result of this disease. The quality of life is significantly reduced. The treatment of this condition depends on the cause. There are no particular complications, but complete healing cannot be guaranteed.

When should you go to the doctor?

Because Pediatric Acute-onset Neuropsychiatric Syndrome is a congenital disorder that does not go away on its own, it must always be evaluated and treated by a doctor. Only medical treatment can limit the symptoms to such an extent that the person concerned can lead a normal life.

The doctor should be consulted if the affected child suffers from depression, anxiety or irritability at a young age. It can also lead to severe sleep disorders, which have a very negative effect on school performance. The children are often aggressive due to the pediatric acute-onset neuropsychiatric syndrome or suffer from memory disorders, so that the child’s development itself is significantly slowed down and hindered. A doctor should also be consulted if the person concerned suffers from tics or obsessive thoughts.

Pediatric Acute-onset Neuropsychiatric Syndrome can be diagnosed and treated by a psychologist. The earlier the diagnosis of the disease occurs, the higher the chance of a complete cure. As a rule, the life expectancy of the patient is not negatively affected by the Pediatric Acute-onset Neuropsychiatric Syndrome.

Treatment & Therapy

There is no generally accepted treatment for the causes of Pediatric Acute-onset Neuropsychiatric Syndrome. The reason for this is that both PANS and its subgroups PANDAS and PITANDS are still in the research phase. For this reason, the therapy of the syndrome is limited to the symptoms.

The NIMH Institute names antibiotic and immune-based forms of treatment as possible therapy options. If bacteria are the trigger of Pediatric Acute-onset Neuropsychiatric Syndrome, antibiotics can be administered to prevent further flare-ups. However, antibiotics are not routinely administered because the relevant research has not yet been completed.

So far only the study results of the PANDAS subgroup exist. To prevent the condition from becoming chronic, most doctors recommend starting treatment for PANS as early as possible. In Europe, the pediatric acute-onset neuropsychiatric syndrome has been included in a guideline on Tourette’s syndrome and other tic disorders since 2011.

The German Society for Child and Adolescent Psychiatry also emphasizes the need to treat PANS in children who have only recently developed obsessive-compulsive disorders.

Outlook & Forecast

The rapid onset of Pediatric Acute-onset Neuropsychiatric Syndrome (PANS or PANDAS) affects children. It is a systemic neurological disease that progresses chronically. It can be triggered, for example, as a result of surviving an infection with streptococci. The syndrome can also present with fluctuating symptoms. However, it is always a lifelong condition. This affects the chances of healing.

This suddenly onset disease is accompanied by numerous disorders from the neurological and psychological environment. Today there are neuropsychiatric and immunological treatment approaches for the pediatric acute-onset neuropsychiatric syndrome. Antibiotics are intended to nip infections in the bud or treat them preventively.

The researchers are still in the process of researching this disease, its causes and possible treatment approaches. Therefore, the prognosis for the pediatric acute-onset neuropsychiatric syndrome cannot be adequately assessed at this time. It could be improved in the future. The earlier the Pediatric Acute-onset Neuropsychiatric Syndrome is diagnosed and its cause identified, the better the prognosis. Treatment works well for some patients. you are recovering.

However, if the cause is not known and the treatment does not work, things look worse. If further infections can be suppressed or prevented, the chronic course of the pediatric acute-onset neuropsychiatric syndrome can often be slowed down.


To date, there are no recommended preventive measures against pediatric acute-onset neuropsychiatric syndrome. The exact causes of the syndrome are still unclear.


In most cases, those affected with Pediatric Acute-onset Neuropsychiatric Syndrome have only a few or limited follow-up measures available. Those affected by this disease should consult a doctor very early on, so that other complications or other symptoms do not occur. The earlier the diagnosis is made, the better the further course of the disease.

During the acute treatment and often for a long time afterwards, those affected are dependent on taking various medications in order to relieve the symptoms of the disease permanently and, above all, correctly. The instructions of the doctor must always be observed, whereby those affected should also contact a doctor first if they have any questions or if there are severe side effects.

If the syndrome is treated with antibiotics, alcohol should not be consumed during treatment. Children who suffer from Pediatric Acute-onset Neuropsychiatric Syndrome need special support and encouragement from their parents. Above all, intensive support at school is very important so that complications do not arise in adulthood.

You can do that yourself

In addition to medicinal measures for the various symptoms, you can also contribute to improving the quality of life on your own.

The first priority here is to avoid any physical exertion, as the body is severely weakened by the severe immune reaction. In addition, it is important to clarify any other symptoms that may arise with the doctor so that, in case of doubt, the therapy can be adjusted and intensified at an early stage. In particular, the occurrence of fever or chills are clear signs of deterioration and require immediate treatment.

In order to support the body in self-healing, it is also advisable to change your diet to light food and drink enough fluids. In the case of sick children in particular, parents should ensure that they drink more water, as they tend to dehydrate more quickly than adults.

In the acute phase of the disease, contact with children or people with a weakened immune system must be avoided as far as possible due to the high risk of infection. But even people who do not belong to a risk group can easily become infected and should pay attention to appropriate hygiene.

If symptoms such as behavioral problems still remain after the disease has subsided, these can be treated with good success by undertaking behavioral therapies. Here, one’s own behavior is analyzed, possible problems are uncovered and a rethinking is encouraged.