Understanding the Difference Between PANDAS and PANS
PANDAS and PANS are related but distinct diagnoses. Understanding the difference matters for how your child gets evaluated, who is qualified to assess them, and what treatments are considered.
PANDAS: The Specific Diagnosis
PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. The trigger is specifically Group A Streptococcus. Clinical criteria (Swedo/NIMH): OCD and/or tic disorder, pediatric onset, abrupt onset or episodic course with sudden dramatic exacerbations, temporal association with Group A Strep infection, associated neurological abnormalities.
PANS: The Broader Umbrella
PANS stands for Pediatric Acute-onset Neuropsychiatric Syndrome. It captures children who have the same abrupt-onset neuropsychiatric presentation as PANDAS but whose trigger is not strep or not yet identified. Triggers may include other bacterial infections (Mycoplasma pneumoniae, Lyme), viral infections (influenza, EBV, COVID-19), metabolic disturbances, or environmental factors. PANDAS is a subset of PANS.
Why the Distinction Matters
The distinction affects: antibiotic prophylaxis decisions (strep-specific in PANDAS), diagnostic workup scope (PANS requires broader infectious disease and metabolic evaluation), insurance coverage arguments for IVIG (strep evidence strengthens prior auth for PANDAS), and treatment selection.
Why Tracking Matters for Both
Whether your child's diagnosis is PANDAS, PANS, or still being determined, the tracking requirements are the same. A family that walks into a PANDAS/PANS evaluation with six months of structured data has a fundamentally better chance of reaching the right diagnosis quickly than a family that relies on verbal recall.
PANDAS Tracker works for both PANDAS and PANS families. Free on iOS and Android.