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Published on: November 21, 2013
Pediatric acute-onset neuropsychiatric syndrome: A single-center retrospective study
Yaping Zheng1, Yu Zhang1, Yuhang Li1
1Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, 400014, China.
Insights
Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) in children is often triggered by infection and presents with diverse neuropsychiatric symptoms. This study found immunotherapy did not shorten PANS symptom duration in a small cohort.
Area of Science:
- Pediatric Neurology
- Neuropsychiatry
- Immunology
Background:
- Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) is a complex condition characterized by sudden onset of neuropsychiatric symptoms.
- Infections are frequently identified as triggers for PANS.
- Understanding the clinical profile and treatment efficacy is crucial for diagnosis and management.
Purpose of the Study:
- To delineate the clinical features of children diagnosed with PANS.
- To evaluate the impact of immunotherapy on the duration of PANS symptoms.
- To provide data for improved diagnostic and therapeutic strategies for PANS.
Main Methods:
- Retrospective analysis of medical records from pediatric PANS patients.
- Categorization into immunotherapy and non-immunotherapy groups.
- Comparison of symptom duration between the two groups.
Main Results:
- Observed common symptoms include obsessive-compulsive behaviors, sleep disturbances, academic difficulties, and irritability.
- Infection preceded PANS onset in 76.2% of cases.
- No significant difference in symptom duration was found between children who received immunotherapy and those who did not (p=0.275).
Conclusions:
- PANS is typically infection-triggered and presents with a wide range of neuropsychiatric manifestations.
- In this retrospective study, immunotherapy did not appear to shorten symptom duration in pediatric PANS patients.
- Further prospective research is warranted to definitively assess immunotherapy's effectiveness in PANS.
Aim:
To facilitate the diagnosis of Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) in children, we described the clinical features of a PANS cohort and analyzed whether immunotherapy could shorten the symptom duration.
Methods:
We retrospectively analyzed the medical records of children with PANS at the Children's Hospital of Chongqing Medical University and categorized them into two groups on the basis of whether they received immunotherapy to compare symptom duration.
Results:
Forty-two patients were included. Thirty-three children (76.2 %) had infection within 4 weeks before onset. Thirty-six (88.1 %) children had obsessive‒compulsive symptoms, 5 children (11.9 %) had eating disorders, and one child had both. Other common clinical manifestations included sleep disturbances (76.2 %, 32/42), academic difficulties (73.8 %, 31/42), irritability (66.7 %, 28/42), developmental regression (54.8 %, 23/42), motor abnormalities (52.4 %, 22/42), hallucinations (52.4 %, 22/42), anxiety (50 %, 21/42), aggression (40.5 %, 17/42), hyperesthesia (31.0 %, 13/42), and emotional lability (23.8 %, 10/42). One child had epileptiform discharges on the electroencephalogram (EEG), while the other 41 children had normal EEGs. Brain magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) analysis were normal in all the children. Immunotherapy was used in 12 patients, and there was not a significant difference in symptom duration between the two groups (immunotherapy group: median 17, IQR 14-21; nonimmunotherapy group: median 15, IQR 11-20; p = 0.275).
Conclusions:
PANS is usually triggered by infection and is accompanied by a variety of neuropsychiatric symptoms. In our retrospective small-sample study, immunotherapy did not shorten the duration of symptoms in children with PANS. However, further prospective studies are still needed to confirm its effectiveness.
