Sudden changes in OCD symptoms, tics, eating or behavior deserve a clear history and clinical assessment. This guide helps you record what happened; it is not a test for PANDAS, PANS, strep infection or a gut cause.[1]
You do not have to produce a perfect diary before asking for help. Begin with when the change started, what it interrupted and any infection or treatment record you already have. A few concrete examples are more useful than a long list of possible causes.
Start With the Timing
PANDAS assessment considers abrupt onset or worsening of OCD, tics or both in childhood, their episodic course and the relationship to streptococcal infection. PANS is broader and includes sudden OCD or severely restricted eating with other neuropsychiatric changes. Neither diagnosis follows from an ordinary infection and a tic alone.[1]
| What to Record | A Useful Example of Detail |
|---|---|
| Onset and changes | The date or short period when things changed, and whether symptoms came and went. |
| OCD, anxiety or behavior | What the child was doing or afraid of and how it affected ordinary tasks. |
| Movements or sensory changes | What moved, what felt uncomfortable and what the child said about it. |
| Eating, drinking and sleep | What became difficult, what was still manageable and how sleep changed. |
| Digestion | Pain, bloating, stool changes and their dates. |
| Infections, tests and treatment | The original result, date, medicine and response recorded at the time. |
Keep Case Symptoms in Their Own Context
Giacomo’s case in the GAPS book includes tics involving his eyes and tongue, sensory difficulty with noise, odors and clothing, fears, anger, restricted food choices, abdominal pain, bloating, constipation, unusual stools, difficulty falling asleep and nightmares. It also includes earlier febrile seizures and episodes described as absences.[2]
These are details in one boy’s history, not a list every child must match. His dramatic change around five and his arrival at Dr. Coro’s clinic at ten are different points in that history. The overview keeps the full chronology and reported outcome together.
Describe Movements Without Judging the Child
The movement FAQ advises quiet observation rather than reacting to each behavior and suggests reviewing recently introduced foods. Record what you actually saw and any information from the child, without having to decide that the movement was deliberate or attention-seeking.[3]
A new involuntary movement, a staring spell or a change in awareness needs its own assessment. It should not be assigned to PANDAS or to a food from this checklist. If there is a seizure, reduced responsiveness or immediate danger, seek urgent medical help.
Bring Sensory and Digestive Details Together
The GAPS sensory FAQ describes gut-related influences on sensory processing in several conditions. If sound, clothing, light or a food texture has become hard to tolerate, note the setting and what changed. That information can guide the conversation without establishing brain toxicity or a neurotransmitter deficiency.[4]
Keep digestive symptoms and recent food changes beside the dates rather than assuming they explain every behavior. The gut and immunity guide explains the source’s proposed connections, while the food guide handles the practical phase and introduction questions.
Keep Infection Records and Current Care Visible
Bring the actual strep test result and date if you have one. If there was no test, record the illness as it was described at the time rather than labeling it confirmed strep. A clinician decides what evaluation or treatment is needed; there is no single laboratory test that confirms PANS or PANDAS.[1]
List current medicines, supplements and any recent changes agreed with the treating team. A new symptom is not a reason to stop antibiotics or psychiatric treatment on your own. If the child cannot maintain fluids or there is an immediate safety concern, get urgent medical help rather than waiting to complete the record.
Bring One Clear Question
You might begin with: “This is when it changed, this is what my child could no longer manage, and these are the infection and treatment records I have.” If a date is uncertain, say so. The aim is a useful conversation, not a perfectly filled form.
My Care Team Log is intended to keep those observations and questions together. A notebook works, too. For the broader source account, return to the PANDAS and GAPS overview.
References
- NIMH, PANS and PANDAS: Questions and Answers (revised 2025), definitions, assessment, infection treatment and medication care.
- Campbell-McBride, N. Gut and Physiology Syndrome (2020), A–Z, PANDAS and Giacomo’s case history.
- Campbell-McBride, N. Official GAPS FAQs, Diseases and Symptoms, question 28.
- Campbell-McBride, N. Official GAPS FAQs, Diseases and Symptoms, question 72.
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