Epidemiology

The exact prevalence and incidence of PANS and PANDAS are unknown. A retrospective study of 95,498 children aged 3-12 years estimated an annual PANS/PANDAS incidence of 1 in 11,765.[13] However, based on the prevalence of childhood-onset obsessive-compulsive disorder (OCD) of 1.9% to 3.0% and data showing that 5% of children with OCD meet PANS/PANDAS criteria, the estimated prevalence of PANS/PANDAS is 0.095% to 0.015%.[14][15][16]​ The discrepancy between the two estimates is likely due to different research designs, measures, and populations in the studies.

One study found that 52% of children aged 8-18 years with eating disorders met criteria for PANS.[17] Another small study showed that 9 out of 42 children aged 5-17 years with a sudden, explosive onset or worsening of tic symptoms had their exacerbation historically associated with group A streptococcus (GAS) infection; 11% of them described abrupt changes of tic behaviour occurring within a 6-week period after a streptococcal infection.[18] In practice, ascribing causation to GAS infection associated with neuropsychiatric deterioration is not possible, especially since GAS infections and carrier state are prevalent in school-aged children. Additionally, GAS infection may go undetected due to the asymptomatic nature of rheumatogenic GAS organisms.[19]

PANS/PANDAS are typically first seen in childhood, from age 3 years to the beginning of puberty.[1][2][20]

The average age of onset of PANS ranges from 6.5 years to 8.5 years with a male predominance.[3][7][21]

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