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Table 1 Proposed diagnostic criteria for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome

From: Prevalence of pediatric acute-onset neuropsychiatric syndrome (PANS) in children and adolescents with eating disorders

I.

Diagnostic criteria for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS)a:

 

a. Presence of obsessive–compulsive and/or tics disorder

 

b. Pediatric onset symptoms must begin between 3 years—puberty

 

c. Abrupt onset of symptoms or dramatic symptom exacerbation with a saw-tooth course

 

d. Association with a confirmed streptococcal infection

 

e. Association with other neuropsychiatric symptoms (e.g. choreiform movements)

II.

Diagnostic criteria tor pediatric acute-onset syndrome (PANS)b:

 

a. Abrupt and dramatic onset of OCD symptoms or severe restriction of food intake

 

b. Concurrent and sudden onset of at least two of the following symptoms:

 

 i. Anxiety

 

 ii. Emotional lability/depression

 

 iii. Irritability

 

 iv. Aggression and/or oppositional behaviors

 

 v. Behavioral (developmental) regression

 

 vi. Deterioration in school performance

 

 vii. Sensorimotor abnormalities

 

 viii. Somatic signs and symptomsc

 

c. Symptoms cannot be better explained by a known neurological or medical conditiond

  1. OCD obsessive–compulsive disorder
  2. aAs proposed by Swedo et al.[11]
  3. bAs proposed by Swedo et al.[12]
  4. cSuch as sleep disturbances, enuresis, or urinary frequency
  5. dSuch as Sydenham chorea, systemic lupus erythematosus, or Tourette’s disorder