How to diagnose PANS/PANDAS | Nervous System Strategies | E85

How to Diagnose PANS/PANDAS: Understanding Sudden Behavioral Changes in Your Child

Watching your child’s behavior suddenly spiral can be terrifying and confusing. You may wonder if it’s just a phase, or if something more serious is happening.

Understanding PANS/PANDAS and autoimmune encephalopathy is crucial, because with the right information and diagnosis, you can access the right treatment and start helping your child heal.

In this episode, Dr. Roseann breaks down what parents need to know about diagnosing these conditions and how to recognize the signs of sudden behavioral changes.

In this episode, you’ll learn:

• the signs of PANS/PANDAS in children

• what tests and evaluations are used to diagnose PANS/PANDAS

• how nervous system regulation in children supports recovery

• why early intervention and proper diagnosis make a difference

What’s really happening in the brain

Sudden behavioral changes are one of the hallmark signs of PANS/PANDAS. Infections, like strep, can trigger neuroinflammation, affecting the brain and causing dramatic shifts in your child’s behavior, emotions, and even cognitive abilities.

Key signs include:

• obsessive-compulsive behaviors that appear almost overnight

• intense rage, aggression, or emotional outbursts

• regression in previously mastered skills (like bedwetting or handwriting)

• anxiety or mood swings

Real-life example:

One mom shared how her son, a thriving child, began having severe meltdowns and developed sudden OCD rituals after a strep infection. This is exactly the type of sudden behavioral change that requires evaluation.

It’s not misbehavior—it’s a dysregulated brain.

How to recognize the signs of PANS/PANDAS

Look for abrupt behavior changes—not gradual patterns.

Takeaways:

• sudden, unexplained mood shifts or anxiety

• new rituals or compulsive behaviors

• developmental regression (e.g., bedwetting, poor coordination)

• sudden school refusal or academic decline

Remember: behavior is communication. When we understand the brain is dysregulated, we can take action to support healing.

What tests are used to diagnose PANS/PANDAS?

There isn’t a single test for PANS/PANDAS—diagnosis involves a combination of clinical evaluation and medical history.

Key diagnostic steps:

• Clinical evaluation by a pediatrician or mental health professional familiar with PANS/PANDAS

• reviewing your child’s symptom history

• blood tests to rule out other conditions

• optional QEEG brain mapping to understand neurological impacts

Tip: Track symptoms, infections, and triggers over time to provide helpful information to your healthcare provider.

How is autoimmune encephalopathy different from PANS/PANDAS?

Both conditions involve the immune system attacking the brain, but they have different onset patterns:

👉 PANS/PANDAS is typically triggered by infections, like strep, and involves a rapid onset of symptoms.

👉 Autoimmune encephalopathy often has a slower, waxing-and-waning progression of symptoms.

Both conditions can cause:

• emotional dysregulation

• cognitive decline

• behavioral changes

• academic difficulties

Early evaluation by a knowledgeable healthcare provider is key to distinguishing these conditions.

Can early intervention improve outcomes?

Absolutely. Early recognition and tailored care make a significant difference in recovery.

Effective interventions include:

• Brain-focused therapies like neurofeedback to calm dysregulation

• Symptom-specific treatments such as medication, therapy, and nutritional support

• Parental co-regulation to help your child feel safe and supported

What you can do while awaiting diagnosis

While waiting for a formal diagnosis, focus on supporting your child’s nervous system and creating stability.

Here’s what you can do:

• keep a behavior and trigger journal

• maintain predictable routines to reduce stress

• focus on nervous system calming strategies

• advocate for your child with healthcare providers

Remember, it’s not about rushing a cure—it’s about creating a stable environment that supports healing.

Listen + Take the Next Step

If this episode helped you understand PANS/PANDAS, share it with another parent who needs clarity on their child’s behavioral changes.

Get your FREE Regulation Rescue Kit here:

👉 www.drroseann.com/newsletter

Dr. Roseann Capanna-Hodge helps parents understand Emotional Dysregulation in Children and teaches practical Nervous System Regulation in Children and Co-Regulation Techniques through her Regulation First Parenting™ approach.

For more information, you can read these blog posts on How to Diagnose PANS and PANDAS (https://drroseann.com/how-to-diagnose-pans-and-pandas/) and Basic Blood Tests for PANS and PANDAS (https://drroseann.com/basic-blood-tests-for-pans-and-pandas/).

Mentioned in this episode:

Get the FREE Self-Regulation Guide!

Do you have a child who gets dysregulated at the drop of a hat, maybe they're cranky and moody and rigid and inflexible? Well, I've got the key to unlock the secrets of successful self-regulation for your child. Get our free resource guide - 147 therapist endorsed self-regulation strategies for children. It's a practical guide for parents and it's a game changer. You can access your copy now and discover practical strategies endorsed by therapists like me, don't miss out and download here:

Self-Regulation