A diagnosis of PANDAS and PANS means a child has had a sudden, dramatic change in personality displayed as Obsessive Compulsive Disorder ( OCD) together with accompanying symptoms following a strep, bacterial or viral infection. Particularly in a very young child, OCD can display as intense fears or anxiety. 

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Symptoms may show a fluctuation pattern as the child heals, Symptoms often return or worsen when the child gets another infection or is exposed to new illnesses, even if they themselves do not have obvious symptoms like a sore throat or fever. Infections need to be eradicated. Over time, episodes can me more intense. 

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Researchers have begun to substantiate that this disease involves a misdirected autoimmune process that affects or weakens the blood brain barrier.

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This is an inflammatory process that irritates a region of the brain called the basal ganglia. The basal ganglia are a group of structures that are an important "switching station" in the deepest inner region of the brain. This area manages a variety of functions such as movement, cognitive perception, habit, executive "logic-based" thinking, emotions, and the endocrine system.

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The majority of the research has involved the strep throat bacteria, but efforts are being made to identify other known infectious agents. Subsequent episodes can be caused by other environmental and infections triggers different than the original infection.