الفهرس 
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infection (PANDAS): Historical PerspectiveOnly 14 pages are availabe for public view
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Abstract
Streptococcal infection in children is usually benign and selflimited,
however, in a small percentage of children, prominent neurologic
and/or psychiatric sequelae can occur. PANDAS (Pediatric Autoimmune
Neuropsychiatric Disorders Associated with Streptococcal infection) is a
well-defined syndrome in which tics (motor and/or vocal) and/or OCD
consistently exacerbate in temporal correlation to a GABHS infection.
The proposed pathophysiology of PANDAS begins with GABHS
infecting a susceptible host. An autoimmune reaction occurs, resulting in
production of brain tissue specific antistreptococcal antibodies, which
triggers an inflammatory response. The autoantibodies react with basal
ganglia proteins, particularly in the caudate nucleus and putamen.
Obsessions, compulsions, tics and other neuropsychiatric symptoms, arise
from interaction between these antibodies and neurons in the basal
ganglia via an unknown mechanism.
Egyptian children suffering from RF (with or without chorea) are
susceptible for PANDAS. Incidence of PANDAS is more in resistant
chorea patients (33%), with females being more affected. The most
common neuropsychiatric manifestations in this subgroup includes OCD
associated with ADHD, followed by OCD + tics + ADHD, then tics +
ADHD, and finally OCD + tics.
Swedo et al., 1998 proposed five diagnostic criteria:
1. The presence of OCD or a tic disorder or both.
2. Pediatric onset.
3. Episodic course of symptom severity with abrupt onset or dramatic
symptom exacerbations.
4. Temporal association with GABHS infection.
5. Association with neurological abnormalities during symptom
exacerbations.