The PANDAS Controversy: Why (and How) Is It Still Unsettled?

Acute-onset OCD and/or tics in children, known by the term Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus (PANDAS), has been a focus of pediatric developmental and psychiatric research for nearly three decades. Studies have suggested that this condition results from molecular mimicry, in which anti-basal ganglia antibodies target brain proteins. While the pathogenesis of this condition is still widely debated, the clinical phenotype has shown consistent features and evidence that the dramatic symptoms cause substantial impairment in the child and in family functioning.