Expert recommendations for diagnosing pediatric acute onset neuropsychiatric syndrome

A panel of leading clinicians and researchers across various general and specialty pediatric fields developed a consensus statement recommending how to evaluate youngsters in whom neuropsychiatric symptoms suddenly develop, including the abrupt, dramatic onset of obsessive-compulsive disorder (OCD). This difficult diagnosis is typically made by pediatricians or other primary care clinicians and child psychiatrists, who will benefit from the guidance provided in the recommendations published in Journal of Child and Adolescent Psychopharmacology, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The article, part of a forthcoming special issue on PANS/PANDAS, is available free on the Journal of Child and Adolescent Psychopharmacology website until November 22, 2014.

Representing the PANS Collaborative Consortium, Kiki Chang, MD, Stanford University School of Medicine (Stanford, CA) and coauthors describe the goals of the First PANS Consensus Conference, from which the expert panel derived its recommendations: to clarify the diagnostic boundaries of PANS, to develop systematic strategies for evaluation of suspected PANS cases, and to set forth the most urgently needed studies in the field. Most cases of PANS appear to be triggered by an infection, and most often an upper respiratory infection.

In the article "Clinical Evaluation of Youth with Pediatric Acute Onset Neuropsychiatric Syndrome (PANS): Recommendations from the 2013 PANS Consensus Conference," the authors detail the core components of a thorough diagnostic evaluation, including family history, medical history, physical examination, psychiatric and mental status exam, laboratory studies, and an infectious disease evaluation.

"This is a watershed moment in our thinking about PANS," says Harold S. Koplewicz, MD, Editor-in-Chief of the Journal of Child and Adolescent Psychopharmacology and President of the Child Mind Institute in New York. "For too long confusion and a lack of understanding concerning this syndrome have left severely impaired children with few, if any, treatment options. This effort promises an improvement in the quality of care and we are grateful to be able support it and to publish our special issue on the topic."