Overview of Treatment of Pediatric Acute-Onset Neuropsychiatric Syndrome

SwedoSusan, E; FrankovichJennifer,; MurphyTanya, K

doi:10.1089/cap.2017.0042

Cited by 84 publications

(67 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…53 Both clinical phenotypes lack robust biomarkers, and pathogenesis remains disputed; however, there is some evidence of immune mediation and immunotherapy responsiveness. 53,54 Although patients may appear to have an acquired brain syndrome, most children with PANDAS or PANS would not fulfill the proposed pediatric AE criteria.…”

Section: Differential Diagnosis Of Aementioning

confidence: 99%

Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient

Cellucci

Mater

Graus

et al. 2020

Neurol Neuroimmunol Neuroinflamm

Self Cite

230

236

View full text Add to dashboard Cite

ObjectiveAutoimmune encephalitis (AE) is an important and treatable cause of acute encephalitis. Diagnosis of AE in a developing child is challenging because of overlap in clinical presentations with other diseases and complexity of normal behavior changes. Existing diagnostic criteria for adult AE require modification to be applied to children, who differ from adults in their clinical presentations, paraclinical findings, autoantibody profiles, treatment response, and long-term outcomes.MethodsA subcommittee of the Autoimmune Encephalitis International Working Group collaborated through conference calls and email correspondence to consider the pediatric-specific approach to AE. The subcommittee reviewed the literature of relevant AE studies and sought additional input from other expert clinicians and researchers.ResultsExisting consensus criteria for adult AE were refined for use in children. Provisional pediatric AE classification criteria and an algorithm to facilitate early diagnosis are proposed. There is also discussion about how to distinguish pediatric AE from conditions within the differential diagnosis.ConclusionsDiagnosing AE is based on the combination of a clinical history consistent with pediatric AE and supportive diagnostic testing, which includes but is not dependent on antibody testing. The proposed criteria and algorithm require validation in prospective pediatric cohorts.

show abstract

Section: Differential Diagnosis Of Aementioning

confidence: 99%

Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient

Cellucci

Mater

Graus

et al. 2020

Neurol Neuroimmunol Neuroinflamm

Self Cite

230

236

View full text Add to dashboard Cite

show abstract

“…Treatment of PANDAS is a complex process that includes not only psychoactive medications but additionally behavioral-cognitive therapy which is offered mainly to those children who present with high levels of distress and anxiety [186,191]. The cognitive-behavioral intervention seems to be a less invasive and expensive way of treatment in comparison to antibiotic therapy or selective serotonin reuptake inhibitors (SSRIs) [77].…”

Section: Psychoactive Drugsmentioning

confidence: 99%

Alterations in the Nervous System and Gut Microbiota after β-Hemolytic Streptococcus Group A Infection—Characteristics and Diagnostic Criteria of PANDAS Recognition

Baj

Sitarz

Forma

et al. 2020

IJMS

View full text Add to dashboard Cite

The objective of this paper is to review and summarize conclusions from the available literature regarding Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). The authors have independently reviewed articles from 1977 onwards, primarily focusing on the etiopathology, symptoms, differentiation between similar psychiatric conditions, immunological reactions, alterations in the nervous system and gut microbiota, genetics, and the available treatment for PANDAS. Recent research indicates that PANDAS patients show noticeable alterations within the structures of the central nervous system, including caudate, putamen, globus pallidus, and striatum, as well as bilateral and lentiform nuclei. Likewise, the presence of autoantibodies that interact with basal ganglia was observed in PANDAS patients. Several studies also suggest a relationship between the presence of obsessive-compulsive disorders like PANDAS and alterations to the gut microbiota. Further, genetic predispositions—including variations in the MBL gene and TNF-α—seem to be relevant regarding PANDAS syndrome. Even though the literature is still scarce, the authors have attempted to provide a thorough insight into the PANDAS syndrome, bearing in mind the diagnostic difficulties of this condition.

show abstract

“…However, immune challenges during fetal development are not the only way the immune system may cause psychiatric symptoms; infection with streptococcal bacteria during childhood has been shown to elicit a rapid onset of psychiatric symptoms in a subset of children, including symptoms of obsessive compulsive disorder and tic-disorders, which could be relieved by e.g. antibiotic treatment 66 . This implicates also gene-environment interactions, i.e., that given a genetic vulnerability, exposure to certain environmental risk factors will increase the risk for disorder development.…”

Section: Neuroimmunology and Psychiatric Disordersmentioning

confidence: 99%

Associations between autistic-like traits and polymorphisms in NFKBIL1

Strenn

Hovey

Jönsson

et al. 2019

Acta Neuropsychiatr.

View full text Add to dashboard Cite

Objective:The immune system has been suggested to be associated with neuropsychiatric disorders; for example, elevated levels of cytokines and the inflammation-related transcription factor nuclear factor kappa-B (NF-κB) have been reported in individuals with autism spectrum disorder (ASD). The aim of this study was to investigate possible associations between autistic-like traits (ALTs) and single nucleotide polymorphisms (SNPs) in NFKB1 (encoding a subunit of the NF-κB protein complex) and NF-κB inhibitor-like protein 1 (NFKBIL1).Methods:The study was conducted in a cohort from the general population: The Child and Adolescent Twin Study in Sweden (CATSS, n = 12 319, 9–12 years old). The subjects were assessed by the Autism-Tics, ADHD, and Other Comorbidities Inventory. Five SNPs within the two genes were genotyped (NFKBIL1: rs2857605, rs2239707, rs2230365 and rs2071592; NFKB1: rs4648022).Results:We found significant associations for two SNPs in NFKBIL1: rs2239707 showed a significant distribution of genotype frequencies in the case-control analysis both for all individuals combined and in boys only, and rs2230365 was significantly associated with the ALTs-module language impairment in boys only. Furthermore, we found nominal association in the case-control study for rs2230365, replicating earlier association between this SNP and ASD in an independent genome-wide association study.Conclusion:The shown associations between polymorphisms in NFKBIL1 and ALTs are supporting an influence of the immune system on neuropsychiatric symptoms.

show abstract

Overview of Treatment of Pediatric Acute-Onset Neuropsychiatric Syndrome

Cited by 84 publications

References 24 publications

Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient

Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient

Alterations in the Nervous System and Gut Microbiota after β-Hemolytic Streptococcus Group A Infection—Characteristics and Diagnostic Criteria of PANDAS Recognition

Associations between autistic-like traits and polymorphisms in NFKBIL1

Contact Info

Product

Resources

About