Despite continued debates about the role of Group A streptococcal infections in the etiopathogenesis of PANDAS\r\n(Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections), experts on both sides of\r\nthe controversy agree that a subgroup of children with obsessive-compulsive disorder (OCD) have an unusually abrupt\r\nonset of symptoms, accompanied by a variety of comparably severe and acute neuropsychiatric symptoms. The acuity\r\nof symptom onset is the hallmark feature of their clinical presentation and the basis for the name proposed for an\r\nexpanded clinical entity: Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). Modifying the PANDAS criteria to\r\neliminate etiologic factors and to clarify the initial clinical presentation produced three potential diagnostic criteria for\r\nPANS. These three criteria are discussed in detail. The article also proposes strategies for applying the PANS criteria\r\nin clinical settings and evaluating their validity and reliability through prospective research investigations.
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