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The curious case of the "inseparable child"

Praveen Navkhare1, Gurvinder Kalra2

  • 1Regional Mental Hospital, Nagpur, Maharashtra, India.

Indian Journal of Psychiatry
|October 16, 2014
PubMed

Insights

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) can manifest unusually. This case highlights abrupt separation anxiety as a rare PANDAS presentation in a child.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Child Psychiatry

Background:

  • Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are rare but serious complications.
  • Common PANDAS manifestations include tics, Tourette's syndrome, and obsessive-compulsive disorder.
  • Less common presentations involve anxiety disorders and attention deficit hyperactivity disorder.

Purpose of the Study:

  • To report a rare case of PANDAS presenting primarily with separation anxiety disorder.
  • To emphasize the importance of recognizing unusual neuropsychiatric symptoms in children with streptococcal infections.
  • To highlight the need for a high index of suspicion for timely diagnosis and treatment.

Main Methods:

  • Case report of a 10-year-old child.
  • Clinical presentation analysis focusing on neuropsychiatric symptoms.
  • Review of literature on PANDAS and its varied manifestations.

Main Results:

  • The patient presented with abrupt onset separation anxiety disorder.
  • No other typical PANDAS symptoms like tics or OCD were observed.
  • This case illustrates an atypical PANDAS presentation.

Conclusions:

  • Streptococcal infections can trigger diverse neuropsychiatric symptoms in children.
  • Clinicians must consider PANDAS even with unusual or isolated symptoms.
  • Vigilance and a high index of suspicion are crucial for diagnosing and managing PANDAS effectively.

Keywords:
Pediatric autoimmune neuropsychiatric disorders associated with streptococcalschool refusalseparation anxiety

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