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Strep throat, caused by the Streptococcus pyogenes bacteria, is one of the most common illnesses in school-age children. In most cases, the physician prescribes an antibiotic that quickly clears up the infection. But in one out of every 200 children, strep triggers an immune response that leads to brain inflammation. Soon after, the child abruptly develops an array of neurologic abnormalities. Pediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS) is a syndrome characterized by the sudden onset of behaviors, including obsessive-compulsive disorder (OCD) and personality changes following a strep infection.

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1. Symptoms of PANDAS

Children who develop PANDAS test positive for recent streptococcal infection, like strep throat (also known as GAS pharyngitis), scarlet fever, or peri-anal strep, an infection of the skin around the anus. Within two to three days — or in some cases, overnight — the child shows signs of emotional instability, irritability, rage, sensory or motor abnormalities, sleep problems, urinary control issues, food refusal, depression, and developmental regression. He or she may also experience unwanted impulses, thoughts, and images called obsessions, which lead to anxiety. The child may lose academic abilities, including handwriting skills. If the child experienced OCD or tic symptoms before the strep infection, their symptoms become worse after developing PANDAS.

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