Inflammation in Tic Disorders and Obsessive-Compulsive Disorder: Are PANS and PANDAS a Path Forward?

J Child Neurol. 2019 Sep;34(10):598-611. doi: 10.1177/0883073819848635. Epub 2019 May 21.

Abstract

This review and commentary is the product of an invited lecture called "Autoimmunity: PANS/PANDAS" presented at the 2018 Neurobiology of Diseases in Children Symposium in Chicago, IL. The talk addressed clinical and scientific questions and recently published data. At this time, among highly experienced and respected clinicians and researchers spanning relevant disciplines, there is substantial controversy regarding a role for inflammation in producing tics and obsessive-compulsive disorder. This commentary summarizes these controversies, discusses reasons for opposing views on best clinical practices, and concludes with suggestions for pathways forward.

Keywords: autoimmune diseases; children placebo; obsessive compulsive disorder; tourette syndrome.

Publication types

  • Review

MeSH terms

  • Autoimmune Diseases / diagnosis
  • Autoimmune Diseases / immunology*
  • Autoimmune Diseases / psychology*
  • Autoimmune Diseases / therapy
  • Humans
  • Inflammation / diagnosis
  • Inflammation / immunology*
  • Inflammation / psychology*
  • Inflammation / therapy
  • Obsessive-Compulsive Disorder / diagnosis
  • Obsessive-Compulsive Disorder / immunology*
  • Obsessive-Compulsive Disorder / psychology
  • Obsessive-Compulsive Disorder / therapy
  • Streptococcal Infections / diagnosis
  • Streptococcal Infections / immunology
  • Streptococcal Infections / psychology
  • Streptococcal Infections / therapy
  • Syndrome
  • Tic Disorders / diagnosis
  • Tic Disorders / immunology*
  • Tic Disorders / psychology
  • Tic Disorders / therapy