title: No Cases of PANDAS on Follow-Up of Patients Referred to a Pediatric Movement Disorders Clinic.
abstract: BACKGROUND
  Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) remains a controversial diagnosis and it is unclear how frequently it is encountered in clinical practice. Our study aimed to determine how many children with acute-onset tics and/or Obsessive-Compulsive Disorder (OCD) met criteria for PANDAS.
  
  
  METHODS
  A retrospective review was performed on 39 children who presented to a movement disorders clinic with acute-onset tics or OCD from 2005 to 2012.
  
  
  RESULTS
  Out of 284 patients seen over the course of 7 years, only 39 had acute-onset tics and/or OCD symptoms. None of the 39 children who presented to us acutely met full criteria for PANDAS. Thirty-eight percent had no association between their symptoms and group A beta-hemolytic streptococcal infection, while 54% had prior inconclusive laboratory testing done and no exacerbations during the course of the study. Only 8% of patients had an acute exacerbation after their initial visit; however, testing for GAHBS in these patients was negative Discussion: Our results support the notion that PANDAS, if it exists, is an exceedingly rare diagnosis encountered in a pediatric movement disorder clinic. While none of our patients met criteria for PANDAS, two with acute-onset OCD would have met criteria for pediatric acute-onset neuropsychiatric syndrome (PANS) indicating that PANS may be a more appropriate diagnosis.
authors.affiliation: Faculty of Medicine, University of Ottawa , Ottawa, ON , Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Kilbertus
authors.affiliation: Department of Neurology, Children's Hospital of Eastern Ontario (CHEO) , Ottawa, ON , Canada.
authors.forename: Renee
authors.initials: R
authors.lastname: Brannan
authors.affiliation: Faculty of Medicine, University of Ottawa , Ottawa, ON , Canada ; Department of Neurology, Children's Hospital of Eastern Ontario (CHEO) , Ottawa, ON , Canada.
authors.forename: Erick
authors.initials: E
authors.lastname: Sell
authors.affiliation: Faculty of Medicine, University of Ottawa , Ottawa, ON , Canada ; Department of Neurology, Children's Hospital of Eastern Ontario (CHEO) , Ottawa, ON , Canada.
authors.forename: Asif
authors.initials: A
authors.lastname: Doja
keywords: OCD; PANDAS; Tourette’s syndrome; streptococcal infection; tics