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Diagnostic Criteria Abrupt, dramatic onset or recurrence of OCD Acute-onset anorexia and/or severe, restrictive eating disorder Concurrent presence of two of the following neuropsychiatric symptoms with severe and acute onset: Separation Anxiety Emotional lability Behavioral/developmental regression Sensory/motor abnormalities handwriting deterioration Deterioration of school performance Urinary symptoms (urgency, frequency, enuresis) Sleep disturbance (difficulty falling asleep, REM disinhibition/restless sleep) Additional Signs and Symptoms There can be many signs, symptoms, and comorbid diagnoses noted in children with PANS/PANDAS including irritability, personality changes, aggression, uncontrolled agitation, fear about bedtime regimen, fidgetiness, emotional lability, motoric symptoms (tics, motoric hyperactivity, compulsive rituals), sensory defensiveness, impulsivity, depression, dysthymia, ADD, and ADHD in addition to those presented in the graphic below