There are invaluable resources to help clinicians and providers learn how to recognize PANS symptoms, do a workup to inform a possible diagnosis and create a treatment plan. ASPIRE has assembled the toolkit below to provide a place to start, but there are many resources throughout the website, and we are always adding more. So, check back often.
PANS Diagnostic Criteria
PANS Consensus Statement on Diagnosing PANS and PANDAS –Clinical Evaluation of Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): Recommendations from the 2013 PANS Consensus Conference. Chang, MD et al (JCAP, Vol 25, No 1, 2015 Mary Ann Liebert, Inc.)
- Abrupt, acute onset of obsessive-compulsive disorder or severely restricted food intake
- Concurrent presence of additional behavioral or neurological symptoms with similarly acute onset and severity from at least 2 of the following categories:
- Emotional Lability and/or Depression
- Irritability, Aggression, and/or Severe Oppositional Behaviors
- Behavioral (Developmental) Regression
- Sudden Deterioration in School Performance
- Motor or Sensory Abnormalities
- Somatic Signs and Symptoms, including Sleep Disturbances, Enuresis, or Urinary Frequency
- Symptoms are not better explained by a known neurologic or medical disorder
- Age requirement – None
The Diagnostic Process
- Step 1: Review Symptoms, Medical History, Physical Exam
- Step 2: Draw Labs to Understand Infections and Immune System Function
- Step 3: Perform Imaging or Other Testing to Rule Out Other Conditions
The PANDAS Physicians Network (PPN) flowcharts for diagnosis and treatment will help clinicians evaluate their patients and determine the best course of treatment. Guidelines and workflows were approved by practitioners of the PANDAS Physicians Network Scientific Advisory Board. More detailed resources are available at www.pandasppn.org. Diagnosing and treating should be done by a licensed healthcare provider.
Primary care providers play important, ongoing roles in the diagnosis, treatment, and recovery of children with PANS/PANDAS. Children with a moderate or severe/life-threatening onset or a complex presentation may require treatment by an experienced multi-disciplinary team of specialists or a PANS/PANDAS specialist. Additional resources can be found at
PANS PANDAS Treatment Guidelines
PANS treatment utilizes three complementary modes of interventions to treat the patient completely. Three-pronged treatment protocols are dependent on disease trajectory, symptoms, and severity as well as lab work and patient history.
- Provide Symptomatic Relief
- Treat Postinfectious Autoimmunity and/or Neuroinflammation
- Treat Source of Infection
The PANDAS Physicians Network (PPN) flowcharts for diagnosis and treatment will help clinicians evaluate their patients and determine the best course of treatment. The diagnostic flowchart and treatment guidelines include a detailed process provided for determining the appropriate diagnosis and symptom severity-based treatment protocols for mild, moderate, and severe/extreme cases.
10 THINGS You Should Know
About PANS PANDAS
PANS/PANDAS Symptoms Tracking Tools
PANS is a clinical condition identified by an abrupt onset of a specific cluster of symptoms as a result of a variety of etiologies and disease mechanisms. Therefore, tracking symptoms, onset, severity, and duration is a critical part of making a clinical diagnosis and forming treatment plans. There are two useful PANS Symptom Rating Scale tools.
ASPIRE PANS PANDAS Resources for Providers
PANS PANDAS Clinician Toolkit
There are invaluable resources to help clinicians learn how to recognize PANS PANDAS symptoms, do a workup to inform a possible diagnosis, and create a treatment plan. ASPIRE has assembled this one-page Clinician Toolkit but there are many resources throughout the website, and we are always adding more. So, check the website often.
Diagnosis & Treatment of PANS PANDAS – Provider Packet
Click the button below to download the twelve-page information packet Provider Information on PANS PANDAS including Symptoms, Diagnosis, and Treatment.
PANS PANDAS Overview of Symptoms, Diagnosis, Treatment
Click the button below to download the eight-page information packet Overview of PANS PANDAS including Symptoms, Diagnosis and Treatment.
Register with ASPIRE to download this information packet.
School Nurse Role & PANS/PANDAS
School Nurses play an integral role in the health of students. They support students and student health every day of the year. Children with PANS/PANDAS have complex physical and mental health conditions that benefit from the support of a School Nurse.
Register with ASPIRE to download the PANS PANDAS School Nurse Overview information packet and share this page.
Nurses’ Role in PANS/PANDAS
Nurses are an integral part of the PANS PANDAS team. Nurses are often the first point of contact during an office visit. It is crucial for nurses not only to recognize PANS/PANDAS symptoms but also to understand how assessments are done and the basics of the treatment guidelines.
Occupational Therapy for PANS/PANDAS
During flares, it’s often difficult for those with PANS PANDAS to relearn skills impacted by the flare. The Occupational Therapist adapts or provides accommodations for activities that are more difficult. Once the flare begins to subside, the therapist is then able to support the child to relearn any skills they may have lost during the flare. This might include handwriting therapy, feeding therapy, self-regulation training, etc.
Behavioral Health for PANS PANDAS
PANS/PANDAS (Pediatric Acute-Onset Neuropsychiatric Syndrome) – Is a syndrome seen in children often misdiagnosed as a primary psychiatric problem and therefore mistreated. Across the US, hundreds of children develop PANS/PANDAS and are referred to mental health clinics or psychiatrists. Mental health treatment alone cannot help reverse the devastating effects of this extremely debilitating syndrome.
PANS PANDAS Research
Supported by novel animal disease models and clinical research, key advances in our understanding of PANS, PANDAS, post-infectious basal ganglia encephalitis (BGE) and immune-related encephalopathies have emerged over recent years. Large epidemiological studies continue to support the relationship between infectious triggers and neuropsychiatric disorders. Advances in our understanding of neuroimmune dysregulation are shaping future findings in diagnostic and treatment outcomes.
Conference & CME Videos
Visit the ASPIRE section on Conference Videos and CME Webinars.
More Clinician Resources
ASPIRE continues to provide more resources for clinicians, patients, families, schools, legislators, and more. Look here for interviews with researchers, providers.