Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a neuropsychiatric syndrome that develops after a Streptococcus pyogenes (group A strep) infection. It is marked by the sudden start or worsening of obsessive-compulsive symptoms and/or tics in prepubertal children, with symptoms that come and go and often appear suddenly across different areas. The chapter explains that much of the ongoing debate stems from challenges in research methods, including the prevalence of strep, silent infections, limited testing, and study design issues. At the same time, it brings together evidence from clinical observations, brain studies, immune markers, animal and lab research, treatment trials, and long-term studies that support a link between strep and a specific group of acute-onset cases. The main point is that accurately recognizing PANDAS depends on timing, symptom pattern, and careful infection screening, and that the way PANDAS develops is similar to other immune-related problems that follow strep infections.
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