This medical condition has either been superseded or has become inactive
| Specific Conditions |
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| Level of Evidence | Evidence of probable benefit – more research needed (Category 2a) |
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PANDAS was first described in the early 1990s. PANDAS is characterised by rapid-onset tics associated with obsessive-compulsive disorder (OCD) in the context of recovery from streptococcal infection. Molecular mimicry between streptococcal antigens and the central nervous system is thought to underlie the cause. Symptomatic therapy is used with variable response. A single randomised placebo-controlled trial using intravenous immunoglobulin (IVIg) for PANDAS showed very prolonged and significant improvement in obsessive-compulsive symptoms, anxiety, depression, emotional lability and overall function compared with placebo. Improvements in symptoms were still evident at one-year follow-up. Refer to the current product information sheet for further information. The aim should be to use the lowest dose possible that achieves the appropriate clinical outcome for each patient. |
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| Bibliography |
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| Singer, HS 1999, ‘PANDAS and immunomodulatory therapy’, Lancet, vol. 354, no. 9185, pp. 1137–8. Perlmutter, SJ, Leitman, SF, Garvey, MA, et al 1999, ‘Therapeutic plasma exchange and intravenous immunoglobulin for obsessive-compulsive disorder and tic disorders in childhood’, Lancet, vol. 354, no. 9185, pp. 1153–8. |