Sudden Onset Complex Tic Associated with Streptococcal Infection in a Neonate: The First Case of Neonatal PANDAS

Richard E Frye


Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is defined by acute onset of neuropsychiatric symptoms, most notably simple or complex motor or vocal tics, with an abrupt onset before adulthood associated with a Group A Streptococcal infection. This disorder is most commonly diagnosed in childhood presumably because of the high incidence of Group A Streptococcal infections during this time in development. This is the first report of a neonate with PANDAS. The neonate presented with clinical and laboratory evidence of a non-invasive Group A Streptococcal infection and concomitantly developed a complex tic. The complex tic waned as the Group A Streptococcal antibody titers decreased suggesting a temporal relation between the two. Infection and other triggers should be considered when abrupt changes in behavior or development occur early in life. Such an increased index-of-suspicious of PANDAS or Pediatric Acute-Onset Neuropsychiatric Syndromes (PANS) early in life may lead to improved neurodevelopmental outcomes.


movement disorder, neonate, pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, pediatric acute-onset neuropsychiatric syndromes, streptococcal infection

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