International Guidelines
Clinical guidance for diagnosis and management of PANS in the Nordic Countries
(2021)
Clinical guidance and treatment aims
These guidelines, co-authored by British Paediatric Neurology Association members, recommend a comprehensive medical history work-up which includes symptom assessment related to infectious, autoimmune and rheumatic diseases as well as psychiatric, neurologic and neurodevelopmental diseases. The treatment aims outlined in the Nordic countries guidelines are threefold: treating ongoing verified infections, suspected inflammation and mental health symptoms.
Pfeiffer, H., Wickstrom, R., Skov, L., Sørensen, C., Sandvig, I., Gjone, I., Ygberg, S., de Visscher, C., Nordstrom, S., Herner, L., Hesselmark, E., Hedderly, T., Lim, M., Debes, N., Acta Paediatrica. 2021;110:3153–3160.
Clinical management of Pediatric Acute-Onset Neuropsychiatric Syndrome
(Parts I, II, and III, 2017)
Part 1 – Psychiatric and Behavioural Interventions
Thienemann, M., Murphy, T., Leckman, J., Shaw, R., Williams, K., Kapphahn, C., Frankovich, J., Geller, D., Bernstein, G., Chang, K., Elia, J., Swedo, S. (2017) Journal of Child and Adolescent Psychopharmacology. V27(7) pp1-8
Part 2 – Use of Immunomodulatory Therapies
Frankovich, J., Swedo, S., Murphy, T., Dale, R. C., Agalliu, D., Williams, K., Daines, M., Hornig, M., Chugani, H., Sanger, T., Muscal, E., Pasternack, M., Cooperstock, M., Gans, H., Zhang, Y., Cunningham, M., Bernstein, G., Bromberg, R., Willett, T., Brown, K., Farhadian, B., Chang,K., Geller, D., Hernandez, J., Sherr, J., Shaw, R., Latimer, E., Leckman, J., Thienemann, M., PANS PANDAS Consortium (2017) Journal of Child and Adolescent Psychopharmacology. V27(7) pp1-16
Part 3 – Treatment and Prevention of Infection
Cooperstock, M., Swedo, S., Pasternack, M., Murphy, T.; for the PANS PANDAS Consortium (2017) Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Journal of Child and Adolescent Psychopharmacology. V27(7) pp1-13
The PANS PANDAS Steering Group does not recommend any particular guidelines. However, in the absence of NICE guidelines, if patients want to share the existing international peer-reviewed guidelines with their doctors for them to use at their discretion, they may do so. Please note that there is no current requirement for doctors to follow them.