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Children are exposed to infections all the time. Most common illnesses cause symptoms for a few days, and with the help of medication, a child returns to their usual self. There are other infections, however, that lead to more severe conditions. Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) is one example. Children with PANDAS are found to have strep throat, the infection that triggers symptoms of obsessive-compulsive disorder (OCD), eating disorders, or other psychiatric conditions. 

Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) is another example of a disorder associated with infections, but not necessarily strep. Infections connected to PANS may include Lyme disease, mononucleosis, walking pneumonia, and the flu.

Some symptoms distinguish PANDAS from PANS. Because a diagnosis is based on the symptoms you report, it is crucial to know what to look for if you think your child may have the disorder.

Follow this helpful PANS symptoms checklist below.

Diagnosing PANS

To be diagnosed with PANS, a child must meet specific criteria. OCD or restrictive eating is almost always present. Along with that, children must exhibit at least two of the following:

  • Anxiety, such as separation anxiety, panic, or generalized
  • Behavioral regression
  • Emotional lability or depression
  • Aggression or irritability
  • Academic decline
  • Sleep disturbances
  • Motor or sensory abnormalities

Below is a more detailed description of the criteria. You can use the criteria as a checklist to guide you in providing the most accurate information to your child’s doctor.

Sudden Onset of Obsessive Compulsiveness

Obsessive-compulsive disorder (OCD) typically occurs over time and gradually worsens. With PANS, the onset of OCD seems to happen overnight. Your child may not have any OCD symptoms one day, and then suddenly, they begin to have uncontrollable obsessive thoughts and compulsions.

Examples of OCD symptoms include

  • Perfectionism
  • Guilt or fixation on morals or religious issues
  • Fear of being out of control
  • Fear of contamination
  • Checking
  • Repeating
  • Washing or cleaning
  • Avoidance 


Pans Symptoms Checklist: A Helpful Guide - Lyme Mexico


Sudden Onset of Severe Eating Restriction

Eating restrictions refer to the foods a child eats and the fluids they drink. A child may develop sensory issues regarding food, like smell, texture, taste, or sound. A child may also exhibit the following with restricted eating in PANS:

  • Eating rituals
  • Lack of appetite
  • Trouble swallowing
  • Body image problems
  • Fears of choking, vomiting, and contamination
  • Avoidance of some foods and drinks

Sudden Onset of Mental Health Symptoms

PANS can trigger the onset of a range of mental health symptoms. A child may begin refusing to attend school or become aggressive when getting ready to go to school. One reason may be they are having separation anxiety and fear leaving the security they feel around parents or loved ones. Aggressiveness, in the form of oppositional defiance, may appear at home or school. Some children exhibit rage that can be overwhelming for everyone. 

Children may also have generalized anxiety, depression, or both. Symptoms of anxiety can include excessive worry, nervousness, panic attacks, and phobias. Symptoms of depression may include sadness, tearfulness, oversleeping, not wanting to get out of bed, and thoughts of suicide.

Behavioral regression is another symptom connected to PANS. A child may start reverting to a younger age and the behaviors associated with that age. Some children may throw tantrums, speak in baby talk, or suck their thumbs.

Sudden Onset of Sensory and Motor Issues

Having sensory and motor changes are common among children with PANS. Sensory abnormalities may involve one or all of the senses of taste, smell, touch, hearing, and vision. Some may exhibit sensory-seeking behaviors, while others may have avoidance behaviors. Symptoms may include:

  • Avoiding certain foods due to texture, taste, smell, etc.
  • Refusing to wear certain clothes due to the way they feel on the body
  • Avoiding hugging or cuddling
  • Overly sensitive to sounds, smells, etc.
  • Difficulty playing with toys or performing tasks
  • Unaware when they bump into things
  • Hallucinations are also possible symptoms, usually visual, but can be with any of the other senses

Children with sensory issues may also become aggressive and desire roughhousing with others. They may also need to constantly move their bodies by pacing, running, or other movements.

Additional motor abnormalities may include the following:

  • Tics and may be diagnosed with Tourette’s Syndrome
  • Hyperactivity and may be diagnosed with attention deficit hyperactivity disorder (ADHD)
  • Uncontrollable urges to move
  • Handwriting problems
  • Choreiform or piano fingers, but jerky and involuntary
  • Clumsiness

Sudden Onset of Sleep Problems

Somatic or sleep problems are common in children with PANS. Some have trouble falling asleep, and others have trouble staying asleep. Factors contributing to sleep problems include OCD, with intrusive thoughts making it hard to relax the mind. 

Some children with PANS have night terrors, causing them to wake up in the middle of the night frightened. This can lead to separation anxiety from parents at bedtime. Other symptoms may include:

  • Frequent daytime urinating
  • Bedwetting
  • Urinary urgency

Sudden Decline in Academic Skills

Children with PANS can experience all of the above symptoms at home and school, making it challenging to keep up with their academic requirements. Students may also lose specific skills, like math and handwriting. In addition, students struggle to remember things and feel like they have brain fog. Those with ADHD symptoms cannot sit still, stay focused, or control impulses.

Finding the Right PANS Doctor

Treating PANS must be done by a qualified and experienced specialist. Because an infection causes PANS, your search should focus on finding an infectious and rare disease doctor. They will know which infections to test for and can use their advanced testing methods to develop an accurate diagnosis.

A PANS specialist will have a specific protocol to treat your child, including

  • Immunotherapy
  • Immunoglobulin therapy
  • Treating the active infection
  • Removing triggers
  • Stem cell therapy
  • Neuro-regenerative peptide therapy
  • Treating adrenal insufficiency
  • Eliminating inflammation

If you think your child may have PANS or PANDAS by reviewing this PANS symptoms checklist, don’t wait to contact the right doctor. Your child deserves the best treatment, which means finding the right doctor regardless of location.

Consider traveling outside the United States, Canada, and the UK to Mexico to meet with a top clinic, Lyme Mexico. We can discuss your symptoms and the alternative treatment options that work.


Pans Symptoms Checklist: A Helpful Guide - Lyme Mexico

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