We created our Stanford PANS program in 2012 in order to build a comprehensive program with the goal to orchestrate groundbreaking research while providing tailored care for patients and their families.
Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) Care
Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), Pediatric Autoimmune Neuropsychiatric Disorder Associated w/ Streptococcal Infections (PANDAS), or Sydenham's chorea (with psychiatric symptoms) present a sudden, seemingly inexplicable change in children, and we understand that getting accurate diagnosis, proper treatment and family support can make a profound difference for both the child’s health and the entire family’s well-being. Our goal is to provide outstanding care based on groundbreaking research, and to tailor care to your child’s unique combination of symptoms and your family’s personal needs.
Stanford was the first academic institution to start a mutlidisciplinary PANS service. We hosted the first national PANS conference in the spring of 2013 where we worked to create clear diagnostic guidelines.
What are PANS and PANDAS?
Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is a clinical diagnosis given to children who have a dramatic – sometimes overnight – onset of neuropsychiatric symptoms including obsessions/compulsions or food restriction. They are often diagnosed with obsessive-compulsive disorder (OCD) or an eating disorder, but the sudden onset of symptoms separates PANS from these other disorders. In addition, they may have symptoms of depression, irritability, anxiety, and have difficulty with schoolwork. The cause of PANS is unknown in most cases but is thought to be triggered by infections, metabolic disturbances, and other inflammatory reactions.
Like PANS, children with Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) have an acute onset – within 2 to 3 days – of neuropsychiatric symptoms, specifically OCD or tics (involuntary, purposeless movements). However, PANDAS patients test positive for a recent streptococcal infection, such as strep throat, peri-anal strep or scarlet fever. Like PANS patients, they also may suffer from uncontrollable emotions, irritability, anxiety and loss of academic ability and handwriting skills. Although PANDAS was identified as a medical syndrome more than a decade before PANS, it has been classified as a subset of PANS. To date, PANDAS is the only known subset of PANS, but we may discover more causes in the future.
PANS Evaluation and Treatment Guidelines
- Chang K*, Frankovich J*, Cooperstock M, Cunningham M, Latimer E, Murphy T, Pasternack M, Thienemann M, Williams K, Walter J, Swedo S. Clinical Evaluation of Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): Recommendations from the 2013 PANS Consensus Conference. Journal of Child and Adolescent Psychopharmacology, Vol. 25, No. 1, February 2015: 3-13. PMID: 25325534
- Swedo S, Frankovich J, and Murphy T. Overview of Treatment of Pediatric Acute-onset Neuropsychiatric Syndrome. Journal of Child and Adolescent Psychopharmacology, Vol. 27, No. 7, September 2017. ahead of print http://doi.org/10.1089/cap.2017.0042
- Thienemann M, Murphy T, Leckman J, Shaw R, Williams K, Kapphahn C, Frankovich J, Geller D, Bernstein G, Chang K, Elia J, and Swedo S. Clinical Management of Pediatric Acute-onset Neuropsychiatric Syndrome: Part I - Psychiatric and Behavioral Interventions. Journal of Child and Adolescent Psychopharmacology, Vol. 27, No. 7, September 2017. ahead of print DOI: 10.1089/cap.2016.0145
- Frankovich J, Swedo S, Murphy T, Dale R, Agalliu D, Williams K, Daines M, Hornig M, Chugani H, Sanger T, Muscal E, Pasternack M, Cooperstock M, Gans H, Zhang Y, Cunningham M, Bernstein G, Bromberg R, Willett T, Brown K, Farhadian B, Chang K, Geller D, Hernandez J, Sherr J, Shaw R, Latimer E, Leckman J, Thienemann M, and PANS/PANDAS Consortium. Clinical Management of Pediatric Acute-onset Neuropsychiatric Syndrome: Part II - Use of Immunomodulatory Therapies. Journal of Child and Adolescent Psychopharmacology, Vol. 27, No. 7, September 2017. ahead of print DOI: 10.1089/cap.2016.0148
- Cooperstock M, Swedo S, Pasternack M, Murphy T, and for the PANS/PANDAS Consortium. Clinical Management of Pediatric Acute-onset Neuropsychiatric Syndrome: Part III - Treatment and Prevention of Infections. Journal of Child and Adolescent Psychopharmacology, Vol. 27, No. 7, September 2017. ahead of print DOI: 10.1089/cap.2016.0151
Location & Contact Information
321 Middlefield Road
Menlo Park, CA 94025
For established patients, email: firstname.lastname@example.org
Volume 27, Number 7, September 2017
Because PANS is caused by many different disease mechanisms and etiologies, there are three complementary modes of intervention to treat PANS, which is given in overview here.
Authors: Susan Swedo, Jennifer Frankovich, and Tanya Murphy