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Dr. Ilona DuBuske

Pediatric Autoimmune Neuropsychiatric Disorders

PANDAS is an immune-mediated disorder characterized by the abrupt onset of OCD and tics symptoms, often occurring 4 to 6 months after a strep infection.


Strep throat is a common childhood ailment. And chances are, your child may have it before his or her 12th birthday. In most cases, antibiotics prescribed by your doctor will kill the bacteria completely.


But in some rare cases, the ordinary strep infection can cause seemingly unexplained symptoms of OCD-like behavior known as PANDAS: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.


PANDAS is an immune-mediated disorder characterized by the abrupt onset of OCD and tics symptoms, often occurring 4 to 6 months after a strep infection. The symptoms can appear overnight and progress rapidly over weeks. Additional symptoms may include deteriorating handwriting, anxiety attacks, ADHD symptoms, sensory or sleep problems, food restriction, and more.


OCD (obsessive-compulsive disorder) triggers thoughts and behaviors, a person repeats over and over again. Tics are repetitive and sudden movements and sounds, like eye blinking or throat clearing, a child cannot control. It happens when antibodies that should target the strep infection mistakenly attack the healthy brain cells responsible for behavior, cognition, emotion, and movements.


PANDAS is regarded as a pediatric disorder, affecting kids between the ages of 3 and 12.

The risk for a strep infection usually drops off around age 12.


Treatment involves antibiotics, anti-inflammatories, supplements, therapy to control OCD, antidepressants and in extreme cases, immune-modulating therapy, such as intravenous immunoglobulin (IVIG) therapy and plasmapheresis.


In most cases, symptoms can improve vastly over several weeks to several months with a proper treatment but may return with a new strep infection.


Help your kids stay healthy by teaching them good hygiene habits and introducing simple precautions when interacting with people who are sick.

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