NEPANS - Before & After Signs

Before & After PANS - Some visual, behavioral & academic cues

It is not always easy to identify if a child has PANS. Knowing the PANS Diagnostic Criteria (see PANS/PANDAS Info) is a good place to start but you really have to look at the whole picture. It often takes a collaborative effort to identify a child with PANS. The School picture is an essential part of the entire story.

For more detailed information see Manifestations of PANS in the School Setting - Symptoms & Supports

For more information about PANS/PANDAS Diagnostic Criteria, Read More...

“The identification of PANDAS symptoms in the school setting requires a cooperative effort. Any teacher who comes in contact with a child should be alert for sudden behavioral changes. Young children frequently exhibit striking behavior changes, including those due to trauma or significant life changes. Scrupulous observation and careful deliberation are sometimes needed to assess causes. Open and ongoing home — school communication may be essential. PANDAS in the School Setting by Kathy O’Rourke, MA (School Nurse News-2003)

Handwriting Changes

Behavioral Regression, a PANS/PANDAS symptom, is shown here by a patient. You can see the marked difference between the self-portrait during a PANS flare with regression as a symptom and the self-portrait while the child was healing.

Images from:
Susan E. Swedo, M.D. Pediatrics & Developmental Neuroscience Branch NIMH, NIH Intramural Program - Bethesda, MD
Presentation video and slides available in Past Events

Regression

Convalescence

Handwriting changes, correlate with increase in neuropsychiatric symptoms. Prior to acute onset of Tics, the student was able to write neatly but after handwriting becomes almost illegible and not neatly placed on the paper.

Images from:
Susan E. Swedo, M.D. Pediatrics & Developmental Neuroscience Branch NIMH, NIH Intramural Program - Bethesda, MD
Presentation video and slides available in Past Events

Before Acute Onset of Tics

After Acute Onset of Tics

Behavior & Academic Changes

The above two slides are from the NEPANS presentation: PANS/PANDAS IN THE SCHOOL SETTING:
From Symptoms To Supports given to School Nurses and Educators. The presentation is available in School Nurses & Educators
The quotes come from PANDAS: A New Frontier for Occupational Therapy Intervention Janice Tona & Trudy Posner

Image Credit: Designed by Freepik