On 22nd March 2013 Susan Swedo, Chief of the Pediatrics & Developmental Neuroscience Branch at the US National Institute of Mental Health gave a talk on “PANDAS – Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections”. The lecture took place at the Wallenberg Hall in Gothenburg and the event was arranged by the Gillberg Neuropsychiatry Centre in collaboration with The Swedish Child Neuropsychiatry Science Foundation and The Swedish Society for Autoimmune Infection-Triggered Neuropsychiatry.
Dr. Susan Swedo coined the concept PANDAS, which stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, in the 1990’s. In 1998 Dr. Susan Swedo and co-workers published a paper in American Journal of Psychiatry where criteria for PANDAS were launched. Susan Swedo’s research group suggested that the following five criteria should be met:
1) Presence of OCD and/or tic Disorder
2) Prepubertal onset
3) Acute onset and episodic course
4) Association with neurological abnormalities and
5) Temporal relationship between symptom exacerbations and streptococcal infections.
Co-morbid symptoms including sleep disorders, behavioural regression, inability to concentrate, hyperactivity, aggressiveness, learning difficulties, deterioration in handwriting and enuresis are all extremely common. During her talk dr. Swedo discussed treatment with plasmapheresis and steroids as well as antibiotics prophylaxis.
Dr. Susan Swedo also introduced the concept PANS, an acronym for Pediatric Acute-onset Neuropsychiatric Syndromes, which is characterized by
1) Abrupt, dramatic onset or recurrence of obsessive-compulsive disorder
2) Concurrent presence of at least two additional neuropsychiatric symptoms (anxiety, sensory or motor abnormalities, behavioural regression, deterioration in school performance, emotional lability and/or depression, urinary symptoms and sleep disturbances)
3) Symptoms are not better explained by a known neurologic or medical disorder, such as Sydenham chorea, systemic lupus erythematosus, Tourette disorder or others.
During her very informative lecture Dr. Susan Swedo gave many vivid descriptions of PANDAS and PANS from her vast clinical experience. The lecture is available in its entirety on this page.