Most parents are familiar with strep throat, a bacterial infection that causes inflammation and pain. While strep can make a child miserable for a few days, it usually clears up after a round of antibiotics.

However, in a small number of children, strep can trigger PANDAS, which stands for “pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections.”

This unusual group of symptoms includes sudden signs of obsessive-compulsive disorder (OCD), uncontrollable muscle movements or tics, anxiety, depression, moodiness, and sensory problems. Additional symptoms may include:

Experts believe PANDAS is an autoimmune disorder in which a child’s immune system attacks the body’s healthy brain cells. According to WebMD, strep bacteria disguise themselves to look like normal cells. When the immune system fights them, it sometimes also fights the cells that the strep is imitating.

PANDAS typically appears in children age 3 to puberty; reactions to strep are rare after age 12.

Unfortunately, there are no laboratory tests that can diagnose PANDAS, so the diagnosis is considered clinical based upon sudden onset of the symptoms listed above plus a positive throat culture for strep or scarlet fever.

Because PANDAS is associated with strep throat, a child showing symptoms is likely to be treated with a course of antibiotics, allowing the PANDAS symptoms to subside.

replacing your child’s toothbrush during and after antibiotic treatment for strep. It’s also a good idea to request throat cultures on the child’s family members to make sure none are carriers of strep.

The neuropsychiatric symptoms can often be lessened through cognitive behavioral therapy and medications.