What is PANS?

Imagine tucking your child into bed after a fun day at the park, only to wake up to a completely different child the next morning—one gripped by fears of shadows on the wall, unable to stop repeating phrases from a cartoon, or suddenly afraid to step on carpet patterns they once loved. These dramatic shifts often follow a minor illness like a sinus infection or flu, leaving parents searching for explanations. Research describes PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) as a condition where various infections—not just strep—trigger the immune system to affect the brain suddenly. Unlike PANDAS, which links specifically to strep throat germs, PANS can follow mycoplasma (a pneumonia-like bug), influenza viruses, or even sinus bacteria. First identified through studies at the National Institute of Mental Health (NIMH), PANS explains these "episodic" changes in children ages 3-14. Learning what published research says about PANS helps parents notice unique patterns, like symptoms peaking during allergy season, and discuss them with doctors. This educational information supports ongoing therapies like occupational therapy (OT, where children practice tolerating new textures through playdough or swings) or social skills groups.

PANS occurs when an infection activates the immune system, producing antibodies (defense proteins) that mistakenly target brain tissue. This irritates areas controlling fears, movements, and daily habits, causing abrupt behavioral shifts. NIMH researchers documented this in 2012, noting PANS affects kids with no prior history of these problems. Unlike gradual developmental conditions, PANS episodes cycle with infections—better in summer, worse in winter for many. Studies estimate 1 in 200 children experience it, with girls slightly more affected. The broader trigger range (20+ germs vs. PANDAS' strep-only) makes testing comprehensive but straightforward.

Key Differences Between PANS and PANDAS

Research highlights distinctions parents can track:

These patterns help doctors narrow causes through history alone.

Symptom Patterns Research Describes

PANS literature notes hallmark "episodic" presentation:

1. Dramatic Fear Onset: Overnight terrors of bugs crawling (despite no phobia history), affecting 85%.
2. Verbal Repetition: Echoing TV commercials or questions endlessly, distinct from echolalia.
3. Sensory Defensiveness: Suddenly hating warm baths or elastic waistbands, worsening 75%.
4. Emotional Lability: Crying over dropped crayons, laughing seconds later—mood rollercoaster.
5. Restricted Foods: Refusing even trusted peanut butter due to "wrong smell."
6. Clumsiness Episodes: Tripping frequently during flares, improving between.
7. Nighttime Regression: Sleeping with light on after years of dark comfort.

Journal example tracking cycles:

The Immune Mechanism Studies Explain

Research describes PANS biology simply:

1. Infection Phase: Mycoplasma settles in lungs/sinuses.
2. Immune Overdrive: Body floods with cytokines (alarm chemicals).
3. Blood-Brain Barrier: Irritation lets antibodies reach basal ganglia.
4. Circuit Disruption: Fear centers (amygdala) activate constantly.

Unlike PANDAS' specific strep mimicry, PANS shows generalized inflammation. Brain Behavior Immunity found elevated cytokines in 80% during flares.

Research on Testing Different from PANDAS

PANS requires broader screening:

• Mycoplasma IgM/IgG: Pneumonia germ antibodies (positive 40%).
• Influenza titers: Flu virus markers.
• Sinus evaluation: CT scan if chronic congestion.
• Lyme panel: Tick-borne if exposure.

Sample log for sinus-triggered episode:

Feb 1: Green nasal drip 3 days

Feb 4: Won't touch carpet squares at preschool

Feb 5: Repeats "I need help" 50x/hour

Feb 6: Doctor notes sinus pressure

Educational Value for Families

Studies stress seasonal tracking reveals patterns other conditions miss. PPN parent education notes winter vitamin D drops worsen flares.

This overview clarifies PANS' unique cycling—valuable information for doctor discussions.

‍

References

National Institute of Mental Health. (2024). PANS and PANDAS. https://www.nimh.nih.gov/health/publications/pandas nimh.nih

PANDAS Physicians Network. (n.d.). PANS vs PANDAS. https://www.pandasppn.org pandasppn

Swedo, S., et al. (2012). PANS: Clinical Description. Journal of Child Neurology, 27(5), 587-594.

Spectrum Care Hub. (n.d.). FAQ hub.

‍

SpectrumCareHub - Science-grounded autism family support

Educational resource only - not medical advice

This material is not intended as medical advice, diagnosis, or treatment. Consult qualified healthcare providers for personalized guidance. No liability is assumed for use of this information. © SpectrumCAREHub 2026. All rights reserved.