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November 30, 2011

An infectious cause of Mental Illness

PANDAS stands for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. PANDAS describes certain children who develop or have worsening of psychological problems including obsessive-compulsive disorder (OCD), tic disorders such as Tourette’s syndrome, or new onset of agitation or severe hyperactivity in association with a Group A Streptococcal infection. Many of these cases have symptoms that  present like Sydenham chorea with an episodic or sawtooth course.  It is postulated that the mechanism may be an autoimmune disorder which takes place within the central nervous system.  The children with PANDAS usually have dramatic, overnight onset of symptoms, becoming moody or irritable in association with a febrile throat infection.

Interestingly, an autoimmune basis has proposed for many chronic, relapsing neurological disorders. Preliminary results suggest that the PANDAS spectrum may be enlarged to include attention deficit/hyperactivity disorder. Children with PANDAS may have a genetic predisposition, which interacts with a Group A Streptococcal infection to cause dramatic symptomatology.

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