Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) refers to obsessive-compulsive (OCD) or tic disorder that is triggered by a streptococcal infection.
Criteria for the diagnosis:
(1) presence of obsessive-compulsive and/or tic disorder
(2) onset between 3 years of age and the start of puberty (pediatric prepubertal)
(3) episodic in nature (abrupt onset or dramatic/sudden exacerbation)
(4) episodes are temporally related to Group A beta-hemolytic Streptococcus infections
(5) neurological abnormalities occur during symptom exacerbations
where:
• The tic disorder may include Tourette's syndrome.
• Symptoms decrease significantly between episodes and may even disappear only to reappear with the next infection.
Differential diagnosis:
(1) Sydenham's chorea (associated with frank chorea)
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