Comparison Chart:
PANS/PANDAS &
Traditional Childhood OCD
TYPE OF ONSET
PANS/PANDAS:
An abrupt, dramatic onset of behavior changes confirms PANS/PANDAS criteria. Sub-acute flares may occur beforehand.
TRADITIONAL CHILDHOOD OCD:
Typically a more gradual onset, may grow more severe over time without treatment.
CLINICAL COURSE
PANS/PANDAS:
Most patients have acute flares in a relapsing-remitting pattern. While some exhibit persistent symptoms, most show 50–100% shifts in severity, often triggered by infection.
TRADITIONAL CHILDHOOD OCD:
Relatively stable with modest fluctuations in severity. In most OCD cases, over time, the symptom severity varies by 10-25%.
SYMPTOMS ACCOMPANYING OCD
PANS/PANDAS:
Ancillary symptoms have a similar abrupt and dramatic onset. The most common are separation anxiety (92%), behavioral regression (63%), enuresis (52%), and dysgraphia (44%).
TRADITIONAL CHILDHOOD OCD:
Other comorbidities may occur, but do not appear with abrupt and dramatic onset.
TREATMENT
PANS/PANDAS:
OCD and ancillary symptoms usually remit with antibiotics/ immunotherapies. CBT/ERP is helpful for symptom management. SSRIs must be started at an extremely low dose with slow titration.
TRADITIONAL CHILDHOOD OCD:
Effective treatments include CBT/ERP therapy, SSRIs, and their combination. No significant improvements with treatments such as antibiotics or IVIG.
Next Steps When You Suspect PANS/PANDAS
Read Seeing Your First Child with PANS/PANDAS.
A comprehensive overview of PANS/PANDAS covering clinical presentation, diagnostic evaluation, and anticipated outcomes.
Follow the Diagnostic and Treatment Flowcharts.
A detailed guide to the evaluation and diagnostic process for PANS/PANDAS, which includes treatment recommendations based on symptom severity.
Access the Practitioner Directory.
An informational resource for clinicians and families seeking medical professionals experienced in PANS/PANDAS to help form a multidisciplinary care team.