Posts by:
Gabriella True

Defining Clinical Course of Patients Evaluated for Pediatric Acute-Onset Neuropsychiatric Syndrome: Phenotypic Classification Based on 10 Years of Clinical Data
Masterson EE, Miles K, Schlenk N, Manko C, Ma M, Farhadian B, Chang K, Silverman M, Thienemann M, Frankovich J, Frankovich J. Defining Clinical Course of Patients Evaluated for Pediatric Acute-Onset Neuropsychiatric Syndrome: Phenotypic Classification Based on 10 Years of Clinical Data. Dev Neurosci. 2025;47(4):270-286. doi: 10.1159/000545598. Epub 2025 Apr 4. PMID: 40188825.
  • 10-year Stanford IBH study standardizes how PANS patient status and flares are defined, including flare vs recovery, acuity of onset, duration, and trajectory.
  • 74% of patients meeting PANS criteria had a relapsing–remitting course rather than continuous illness.
  • 43% experienced a persistent clinical course (>12 months of impairment), yet 77% ultimately recovered.
  • 57% never developed persistent symptoms and typically had 1–3 flares per year, each lasting about 3 months.
  • Findings reinforce PANS as a heterogeneous, episodic condition where persistence does not rule out recovery.
Sudden Onset Disordered Eating Behaviors and Appetite Issues in a Local Clinical Cohort of Children With Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)
Kapphahn C, Peet B, Gao J, Chan A, Farhadian B, Ma M, Silverman M, Tran P, Schlenk N, Thienemann M, Frankovich J. Sudden Onset Disordered Eating Behaviors and Appetite Issues in a Local Clinical Cohort of Children With Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS). Int J Eat Disord. 2025 Jul;58(7):1219-1232. doi: 10.1002/eat.24388. Epub 2025 Mar 31. PMID: 40165330.
  • 130 youth with PANS (ages 4–18) reviewed at a specialty clinic
  • 56% developed abrupt-onset restrictive eating during flares
  • Eating restriction patterns mirrored ARFID presentations
  • Most affected youth had severe concurrent neuropsychiatric symptoms
  • 12% had baseline eating restriction, often worsened during flares
Bartonella henselae, Babesia odocoilei and Babesia divergens-like MO-1 infection in the brain of a child with seizures, mycotoxin exposure and suspected Rasmussen’s encephalitis
Breitschwerdt EB, Maggi RG, Robveille C, Kingston E. Bartonella henselae, Babesia odocoilei and Babesia divergens-like MO-1 infection in the brain of a child with seizures, mycotoxin exposure and suspected Rasmussen’s encephalitis. J Cent Nerv Syst Dis. 2025 Mar 12;17:11795735251322456. doi: 10.1177/11795735251322456. PMID: 40083671; PMCID: PMC11905044.
  • Despite cat and suspected tick exposure, Bartonella henselae and Borrelia burgdorferi serology remained negative.
  • Neurodiagnostic testing partially supported Rasmussen’s encephalitis; brain biopsy showed astrogliosis.
  • Bartonella henselae DNA was detected in brain tissue cultures.
  • Babesia odocoilei and Babesia divergens-like MO-1 were confirmed in blood and brain tissue from 2022–2023.
  • Infections, compounded by mycotoxin exposure, created a complex clinical case.
Obsessive Compulsive Disorder associated with Autoimmunity in Youth: Clinical Course before and after Rituximab+/- Adjunctive Immunomodulation
Frankovich J, Calaprice D, Ma M, Knight O, Miles K, Manko C, Hernandez JD, Sandberg J, Farhadian B, Xie Y, Silverman M, Madan J, Strand V, Chang K, Thienemann M. Obsessive Compulsive Disorder associated with Autoimmunity in Youth: Clinical Course before and after Rituximab+/- Adjunctive Immunomodulation. Dev Neurosci. 2025 Mar 10:1-26. doi: 10.1159/000544993. Epub ahead of print. PMID: 40064151.
  • Case review (n=23) from Stanford on their use of rituximab for presumed-neuroimmune and severe OCD in youth
  • Some (47.8%) experienced transient increases in psychiatric or joint pain symptoms before signs of improvement. The time frame for signs of improvement was 3-4 months. 
  • 70% achieved full or partial recovery at 1-5 years.
  • Receiving adjunct immunomodulation was associated with a higher likelihood of achieving full or partial recovery compared with those without adjunct immunomodulation