Repeated Flares & Baseline
Do patients go back to baseline between flares/exacerbations?
Not always. Some symptoms can remit fully while others are reduced but not back to baseline.
Note: PANS has multiple triggers, not just strep. This chart uses strep as an example incitatory trigger, but please note that any PANS trigger could replace strep on this chart. Learn more about the definition of PANS/PANDAS.
A single flare can occur, but the disease course of PANS PANDAS typically follows a relapsing and remitting pattern. In between flares, some symptoms may not go back to baseline.
Unfortunately, in some cases, subsequent flares can be more severe with a longer duration; symptoms may move further from baseline and become chronically debilitating. The disease course becomes chronic or static if the majority of symptoms don’t return to baseline between flares.
PANS symptoms can remit completely, especially if treated quickly and thoroughly. Treatment plans should include treatments to clear the current flare and address symptoms that have not returned to baseline. Ultimately the goal is to relieve symptoms and prevent symptoms from becoming chronically debilitating. See Treatments.
PANS PANDAS symptoms relapse when the patient is exposed to a new trigger like a new infection, an untreated infection, environmental challenges, metabolic imbalances, psychosocial stress, injury, etc. The severity of flares will vary, don’t ignore the less severe relapses. Flares can occur often, or several months or years can separate them.