How to Tell If Your Child’s Symptoms Are PANS/PANDAS (And What to Do Next)
If your child’s behaviour changes suddenly and dramatically, leaving you feeling confused, helpless, or dismissed by doctors, you are not alone. Many parents searching for answers to sudden-onset OCD, anxiety, tics, or emotional outbursts eventually come across the terms PANS and PANDAS. But what do they really mean? And how do you know if they apply to your child?
As a Clinical Nutritionist specialising in PANS, PANDAS, Autism, ADHD, OCD and tic disorders I work with parents every day who feel lost in the medical system, unsure of what is happening to their child or what to do next. This guide will help you understand the key signs of PANS/PANDAS, how they differ from other conditions and the first steps toward healing.
What Are PANS and PANDAS?
PANS (Paediatric Acute-Onset Neuropsychiatric Syndrome) and PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) are neuro-inflammation-driven conditions that cause sudden, severe behavioural and neurological symptoms in children.
PANS is triggered by a variety of factors, including infections (bacterial or viral), environmental toxins, immune dysfunction and metabolic imbalances.
PANDAS is a specific subset of PANS where symptoms are triggered by an infection with Group A beta-haemolytic Streptococcus.
Both conditions involve an immune system response that mistakenly attacks the brain, leading to neurological, behavioural and emotional changes.
How Do You Know If Your Child Has PANS or PANDAS?
The most distinctive feature of PANS/PANDAS is the sudden onset of symptoms and remitting and relapsing course (symptoms will flare and then subside or return to baseline).. Parents often describe their child as having changed “overnight” with a very abrupt onset or worsening of symptoms within 24-48 hours of an illness.
Here are the key symptoms to look for:
1. Sudden-Onset OCD, Severe Anxiety, and Restrictive Eating Behaviours
Obsessive thoughts and compulsions appearing seemingly out of nowhere
Extreme separation anxiety, contamination fears, or fear-based rituals
Restrictive eating linked to obsessive fears of choking, vomiting, or food contamination
Sudden food refusal or extreme limitation of safe foods
Weight loss or refusal to eat driven by anxiety or obsessive fear
In PANS and PANDAS, restrictive eating is often not simply fussy eating—it is typically an obsessive-compulsive behaviour, where fear or distress drives a child's avoidance of food.
If your child has developed several of these symptoms seemingly out of nowhere, especially after an illness, PANS or PANDAS could be the underlying cause.
2. Motor or Vocal Tics
Sudden, repetitive movements (eye blinking, facial grimacing, head jerking)
Uncontrollable sounds (throat clearing, sniffing, grunting, echolalia)
3. Emotional and Behavioural Changes
Aggression, rage episodes or extreme mood swings
Emotional outbursts that seem disproportionate to the situation
ADHD like behaviours such as hyperactivity, inattention or fidgeting
Sensory sensitivities (suddenly refusing to wear certain clothing, avoiding noises, food aversions)
4. Regression in Skills or Development
Sudden loss of handwriting skills (messy or illegible writing/drawing)
Difficulty with math or schoolwork they previously understood
Reverting to baby talk or losing language skills
Playing with toys/games or watching TV shows they had outgrown
Bedwetting after being dry for years or increased urination/involuntary urination during the day
5. Sleep Disturbances
New-onset night terrors or frequent nightmares
Difficulty falling or staying asleep
6. Restrictive Eating or Food Avoidance
Extreme food refusal
Fear of choking, vomiting or food contamination
Sudden weight loss due to lack of eating
If your child has developed several of these symptoms seemingly out of nowhere, especially after an illness, PANS or PANDAS could be the underlying cause.
How Do PANS/PANDAS Differ from Autism, ADHD, or Other Behavioural Disorders?
If your child’s symptoms came on suddenly and seem to worsen in flares, this is a strong indicator that PANS/PANDAS may be at play. In some cases children with Autism and ADHD can also have PANS/PANDAS layered on top of their conditions or families will recognize there was mild anxiety present before but post PANS/PANDAS it has become extreme.
What to Do Next if You Suspect PANS or PANDAS
1. Start Tracking Symptoms
Keeping a symptom journal can help identify patterns and potential triggers. Take note of:
When the symptoms started
Any illnesses or infections your child had before symptoms appeared
Any recent vaccinations, environmental exposures, or stressors
2. Consider Medical Testing
PANS and PANDAS is a clinical diagnosis by exclusion meaning all possible causes for the presenting symptoms must be considered. A medical professional may run tests to check for immune markers, infections and inflammation. Some tests that can be helpful include:
Strep titers (for PANDAS)
Inflammatory markers (C-reactive protein, ESR)
Comprehensive stool testing (to assess gut health and microbiome balance)
Organic acids test (to check for metabolic and neurotransmitter imbalances)
GPs and Specialists may also order MRIs, EEGs and lumbar punctures
3. Support the Immune System & Reduce Inflammation
While medical treatment is important, nutrition and functional medicine play a key role in rebalancing the immune response and reducing symptom severity. Some key areas to focus on include:
Gut Health: A significant portion of the immune system is in the gut and restoring microbiome balance can help regulate immune function.
Nutrient Deficiencies: Many children with PANS/PANDAS are low in zinc, iron, magnesium, vitamin D, and omega-3s—nutrients that are essential for brain and immune health.
Anti-Inflammatory Diet: Reducing inflammatory foods (processed foods, artificial additives, gluten) and increasing whole, nutrient-dense foods can help stabilise symptoms.
4. Work with a Practitioner Who Specialises in PANS/PANDAS
Many parents struggle to find doctors or specialists who truly understand PANS and PANDAS. That’s where a functional, holistic approach can make a difference.
As a Clinical Nutritionist, I focus on identifying the root causes of your child’s symptoms and creating a personalised plan that supports their immune, gut and brain health—helping them regain balance and stability.
You Are Not Alone—There Is Hope
Many parents feel unheard and dismissed when trying to get answers for their child. But PANS and PANDAS are real and they are treatable. With the right support, many children experience dramatic improvements in symptoms, behaviour and overall well-being.
If you suspect PANS/PANDAS in your child and are looking for guidance on what to do next, I invite you to book a free 20-minute discovery call. Together, we can create a plan to help your child heal.
