PANS Symptoms Checklist

PANS (pediatric acute-onset neuropsychiatric syndrome) arises from infection. The most common diseases are strep, influenza, Lyme disease, and mycoplasma pneumonia that cause acute-onset, appearing suddenly within a short time frame, neurologic and/or psychiatric symptoms. In some children and adolescents, these infections can trigger an autoimmune response. 

PANS Symptom Checklist - Natural treatment
Sometimes the person you really need is the one you didn’t think you wanted.

Below is a PANS symptoms checklist. Doctors frequently treat the presenting symptoms without addressing the underlying cause. If your child has a rapid onset of neuropsychiatric issues, the underlying cause might be an infection attacking the brain, causing repeated episodes. Use the checklist below to see if your child meets the criteria for a PANS diagnosis.

PANS Symptoms

Access the PANS symptoms checklist below. See a doctor if two or more items appear rapidly and are a departure from a child’s typical behavior:


  • Anorexia
  • Enuresis / urinary issues
  • Sensory disturbances
  • Sensory or motor abnormalities
  • Vocal and/or motor tics of any type, severity, or duration


  • Anxiety or unusual fears, separation anxiety
  • Behavioral or developmental regression
  • Changes in handwriting
  • Deterioration in school performance
  • Emotional lability and/or depression 
  • Impulsivity or distraction
  • Inability to concentrate
  • Irritability, aggression, or rage 
  • Obsessions or compulsions
  • Oppositional or defiant behaviors 
  • Separation anxiety
  • Worry about harm

Obligatory Symptomactic Features

A PANS diagnosis requires two or more sudden onset of the following symptoms. Age Requirement: None.

Acute dramatic anxiety

  • Specific phobias, panic, irrational fears
  • Separation anxiety

Acute onset of one or more motor abnormalities

  • Clumsiness or coordination disorder
  • Dysgraphia especially marked deterioration of handwriting
  • Motors Tics

Developmental regression

  • Change in character of language (dysphagia)
  • Simplifications of vocabulary
  • Infantile quality of voice
  • Loss of skills previously acquired

Emotional lability or symptoms

  • Irritability and aggressive behavior
  • Depression with suicidal or self-injurious thoughts

Sleep disturbances

  • Anxiety preventing sleep
  • Restless legs

Sudden deterioration of learning abilities

  • Concentration difficulties that are perhaps related to instructive thoughts
  • Deterioration in math ability

Urinary symptoms

  • Males and females: frequent bathroom visits with or without polyuria (excessive or abnormally large amounts of urine) that cannot be explained by medical causes such as UTI or hyperglycemia
  • Females only: a sense of vaginal moisture even when dry that causes excessive wiping

Common Misdiagnoses

A child may receive an OCD, ADHD, Tourette’s syndrome, autism, anorexia, or another psychiatric illness diagnosis. If medically treated and the child does not respond to treatment, it could be a PANS-related infection. 


PANS began as a PANDAS diagnosis. However, PANDAS is not a sub-diagnosis of PANS. PANDAS (pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections) relates specifically to a strep infection. PANS is a broader diagnosis that encompasses several underlying neuropsychiatric causing diseases.

The critical part of a PANS or PANDAS diagnosis is “acute-onset,” where the symptoms reach full intensity within 48 hours. The episodic symptoms may disappear, only to reappear. Each time the cyclical symptoms return, the episodes could grow in severity.

What Is Acute Onset OCD?

Typically, OCD symptoms appear gradually. A child may, at first, successfully hide their developing fears and rituals. Eventually, the time-consuming routines from the overwhelming fears become apparent and difficult to conceal.

Acute onset OCD appears nearly overnight and usually accompanied by additional symptoms such as rage, depression, motor tics, and even suicidal thoughts and actions. All the listed symptoms can suddenly appear in children as young as three.

Why is my child anorexic?

Approximately 1 in 5 children with PANS restricts their food intake.

What might be happening to your child?

The child may have developed a fear of specific food or food group. They refuse to eat or drink it because they believe it will cause them harm. The child might believe consuming the item will cause vomiting, choking, or another hazard.

PANS-related food restrictions could also present as anorexia nervosa, where the child grows obsessed with body image and weight.
The distinction with PANS is “acute-onset,” where food restriction intensely appears within 48 hours.

Is my child too old/young for PANS?

Most PANS diagnoses occur in children under 12 years old. However, there is not an age limitation to receive a PANS diagnosis. Therefore, initial symptoms can arise during adolescence.

PANDAS requires an onset of symptoms before puberty. If all criteria are met in post-pubescent patients, age does not preclude them from a PANDAS diagnosis. Studies have shown 98% of those over 12 years old are immune to strep infections. Therefore, a PANDAS diagnosis after puberty will be rare.

BioNexus Health offers natural treatment options for PANS and PANDAS.