This study is an investigation of the neurologic, immunologic, and rheumatologic markers of Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS). PANS is a condition characterized by the abrupt, dramatic onset of obsessive compulsive disorder (OCD) and/or eating restriction accompanied by equally abrupt and severe co-morbid neuropsychiatric symptoms, which include anxiety, emotional lability, depression, irritability, aggression, oppositionality, deterioration in school performance, behavioral (developmental) regression, sensory amplification, movement abnormalities, sleep disturbance, and urinary frequency. PANS is thought to be caused by infection, inflammation, or alternate triggers that is associated with a brain response that leads to these symptoms. The purpose of this study is to examine specific neurologic, immunologic, rheumatologic, and genomic, components in children with the acute-onset of psychiatric symptoms. This research may begin to uncover a much larger story of autoimmune processes that are involved in psychiatric disorders of childhood. By better understanding the etiologic components of psychiatric phenomenon, future treatments may be better targeted to underlying causes.
Children with PANS
Age 1-18 at onset of PANS
Diagnosis of PANS: abrupt onset of OCD or food restriction, and at least two of the following associated symptoms: frequent urination, worsening handwriting/cognition, inattention, anorexia, separation anxiety, oppositionality, irritability/rage outbursts, and emotional lability.
Patients must live within 90 miles of Stanford University and have a new onset of PANS illness
Any neuropsychiatric illness that may obscure the clear diagnosis of PANS
The investigators to enroll 500 children with PANS/PANDAS and 100 healthy controls. Children's parents will also be enrolled to report information about their children as well as their own caregiver burden. The 500 patients with PANS will meet diagnostic criteria. These patients are targeted because this study is seeking to specifically assess the immunologic and neurological markers of PANS.
Cohort
Prospective
Not listed
Cerebral blood flow
The investigators will report results of altered cerebral blood flow from patients with PANS.
EEG patterns
The investigators will report results of abnormal EEG patterns from patients with PANS. All data will be obtained through the review of medical records, which are created during the routine clinical care of patients.
Rapid Eye Movement (REM) motor disinhibition
The investigators will report results of REM motor disinhibition from polysomnography studies. All data will be obtained through the review of medical records, which are created during the routine clinical care of patients.
Global Impairment Scores
All data will be obtained through the review of medical records, which are created during the routine clinical care of patients.
Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS)
All data will be obtained through the review of medical records, which are created during the routine clinical care of patients.
Columbia Impairment Scale
All data will be obtained through the review of medical records, which are created during the routine clinical care of patients.
Caregiver Burden Inventory
All data will be obtained through the review of medical records, which are created during the routine clinical care of patients.
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