Medicine:Pediatric acute-onset neuropsychiatric syndrome
| Pediatric acute-onset neuropsychiatric syndrome | |
|---|---|
| Specialty | Neuroimmunology |
Pediatric acute-onset neuropsychiatric syndrome (PANS)[1] is a disorder characterized by the sudden onset of obsessive-compulsive (OCD) symptoms or eating restrictions, concomitant with acute behavioral deterioration and/or motor/sensory changes in at least two of seven domains.[1] Those domains are anxiety, emotional lability and/or depression, irritability, aggressive or oppositional behavior, academic decline, cognitive decline, and sleep disruption.[1] The diagnosis necessitates a course that follows a relapsing–remitting pattern. In the case of post-puberty chronicity residual symptoms and their severity increases.[2]
OCD and tic disorders are hypothesized to arise in a subset of children as a result of a post-streptococcal autoimmune process.[3][4][5] The earlier PANDAS hypothesis was unconfirmed and unsupported by data, and two new categories were proposed: PANS and CANS (childhood acute neuropsychiatric syndrome).[4][5] The CANS/PANS hypotheses include different possible mechanisms underlying acute-onset neuropsychiatric conditions.[4][5] PANDAS, PANS and CANS are the focus of clinical and laboratory research but remain unproven.[3][4][5]
Diagnosis
PANS is an exclusively clinical diagnosis based on the exclusion of other disorders (exclusion diagnostics) and is characterized by symptoms typical of basal ganglia dysfunction and the results of altered functions of the inert part of the immune system. PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) is basically PANS caused by streptococcal infection and has symptoms similar (but not equal) to PANS. However, the pathological mechanisms of PANDAS are still under research.[6]
References
- ↑ 1.0 1.1 1.2 "Clinical evaluation of youth with pediatric acute-onset neuropsychiatric syndrome (PANS): recommendations from the 2013 PANS Consensus Conference". J Child Adolesc Psychopharmacol 25 (1): 3–13. February 2015. doi:10.1089/cap.2014.0084. PMID 25325534.
- ↑ "Overview of Treatment of Pediatric Acute-Onset Neuropsychiatric Syndrome". J Child Adolesc Psychopharmacol 27 (7): 562–565. September 2017. doi:10.1089/cap.2017.0042. PMID 28722464.
- ↑ 3.0 3.1 "Tics and Tourette: a clinical, pathophysiological and etiological review". Curr Opin Pediatr 29 (6): 665–673. December 2017. doi:10.1097/MOP.0000000000000546. PMID 28915150.
- ↑ 4.0 4.1 4.2 4.3 "Immune system and obsessive-compulsive disorder". Psychoneuroendocrinology 93: 39–44. July 2018. doi:10.1016/j.psyneuen.2018.04.013. PMID 29689421.
- ↑ 5.0 5.1 5.2 5.3 "CANS: Childhood acute neuropsychiatric syndromes". Eur J Paediatr Neurol 22 (2): 316–320. March 2018. doi:10.1016/j.ejpn.2018.01.011. PMID 29398245.
- ↑ "Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part I-Psychiatric and Behavioral Interventions". J Child Adolesc Psychopharmacol 27 (7): 566–573. September 2017. doi:10.1089/cap.2016.0145. PMID 28722481.
External links
 |
