Abstract
In 1994, Susan Swedo and colleagues described children who developed mental health issues following infection with Group A Streptococcus (GAS) infections, and in a subsequent report coined the term Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) [1,2]. In short order it was discovered that multiple microbes have the potential of triggering mental health issues in children and adolescents, and the nomenclature was updated to Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) [3]. The microbes that thus far have been associated with PANS include herpes simplex virus, influenza A virus, varicella virus, HIV, recurrent sinusitis, Epstein-Barr virus, the common cold, Mycoplasma pneumoniae and Bartonella henselae [4-6].
Highlights
The criteria for Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) include the abrupt onset of severely restricted food intake or Obsessive-Compulsive Disorder (OCD) without an underlying medical disorder, accompanied by at least two of the following seven conditions [3]:
Lyme disease is an infection caused by the Borrelia burgdorferi (B. burgdorferi) bacterium
It is clear that children with PANS manifest symptoms that parallel those with neurological Lyme disease
Summary
The criteria for PANS include the abrupt onset of severely restricted food intake or Obsessive-Compulsive Disorder (OCD) without an underlying medical disorder, accompanied by at least two of the following seven conditions [3]:. Lyme disease in children has been reported to cause anxiety, panic attacks, depression, irritability/oppositional disorders, personality disorders, attention deficit hyperactivity disorder, psychosis, OCD, eating disorders, cognitive difficulties with decline in school performance, and many somatic symptoms such as sleep disorder, musculoskeletal pain as well as tics [17,25,26,27,28,29,30,31]. The Cunningham Panel, which includes levels of these antibodies as well as CaMKII activity, was developed to assess patients with PANS-like syndromes.
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