Criterion Description I. Abrupt, dramatic onset of obsessive-compulsive disorder or severely restricted food intake II. Concurrent presence of additional neuropsychiatric symptoms, with similarly severe and acute onset, from at least two of the following seven categories (see text for full description):      1.  Anxiety 2.  Emotional lability and/or depression 3.  Irritability, aggression and/or severely oppositional behaviors 4.  Behavioral (developmental) regression 5.  Deterioration in school performance 6.  Sensory or motor abnormalities 7.   Somatic signs and symptoms, including sleep disturbances, enuresis or urinary frequency III. Symptoms are not better explained by a known neurologic or medical disorder, such as Sydenham chorea, systemic lupus erythematosus, Tourette disorder or others.    Note:  The diagnostic work-up of patients suspected of PANS must be comprehensive enough to rule out these and other relevant disorders.  The nature of the co-occurring symptoms will dictate the necessary assessments, which may include MRI scan, lumbar puncture, electroencephalogram or other diagnostic tests.

Table 2: Diagnostic Criteria Proposed for Pediatric Acute-onset Neuropsychiatric Syndrome (PANS).