PANDAS: Pediatric Autoimmune Neuropsychiatric Disorder Associated with Group A Streptococci – Pediatric Acute Neuropsychiatric Syndrome (PANS) A Comprehensive Review

Abstract Pediatric acute neuropsychiatric syndrome (PANS) and pediatric acute neuropsychiatric disorder associated with streptococcal infection (PANDAS), both are characterized by abrupt fluctuating episodes of obsessive-compulsive symptoms with other symptoms. These episodes are usually proceeded by infections with antigen mimicry speculated to be the cause of an immune dysregulation and inflammatory response. A cumulative data suggest that PANDAS is part of a systemic inflammatory response allowing anti-inflammatory drugs and immune modulator medications to be used for treatment with variable outcomes. In this review we will shed light on documented facts about PANDAS and PANS aiming to raise awareness and improve management approach for affected children. This review synthesizes evidence from clinical studies, epidemiological data, and ongoing research to outline the historical context, pathogenesis, diagnostic criteria, differential diagnosis, treatment protocols, and controversies surrounding PANDAS and its broader counterpart PANS. We aim to emphasize evidence-based approaches while highlighting areas needing further investigation.