If your child suddenly starts blinking uncontrollably, making strange sounds, or suddenly doing jerky movements, you might be wondering what on earth is going on. It’s not just a habit you can tell them to stop—it could be PANDAS or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.

These behaviors aren’t your child acting out; they’re a cry for help from their dysregulated brain. Understanding these tics and movement symptoms is your first step toward getting your child the help they need and deserve.

What is PANS/PANDAS?

First, we need to understand what this mental health condition is. PANS/PANDAS are different clinical conditions that result from a misdirected immune response that manifests in sudden onset of OCD, tics, limited food intake, along with other neuropsychiatric and psychological symptoms too.

These disorders are lesser-known and often misunderstood. Your child’s doctor may not always be familiar with them and often mistakes them for other conditions, making diagnosis and treatment quite challenging. 

What Do PANDAS Motor Abnormalities Look Like?

Are you observing Motor or Vocal Tics in your kids?

Motor Tics: Sudden, repetitive movements like blinking, grimacing, or shoulder shrugging. These movements are the result of inflammation in your child’s basal ganglia, the brain region responsible for motor control. Their brain is sending misfired signals, making them move involuntarily.

Vocal Tics: Involuntary sounds like throat clearing, grunting, or repeating phrases. These tics happen when inflammation disrupts the brain’s regulation of speech and vocalization. Your child isn’t trying to get attention—they physically can’t control it.

Children with PANDAS may also receive a dual diagnosis of a tic disorder, such as an autoimmune disorder such as Tourette’s Syndrome, which shares similar symptoms but has a different cause.

Motor Tics in PANS/PANDAS Syndrome

Choreiform Movements (Piano Fingers)

• Subtle, quick finger or hand movements that resemble playing the piano.

These movements are less dramatic than Sydenham chorea but signal underlying neuroinflammation. You might notice your child’s fingers twitching during quiet activities like reading or watching TV.

Hyperactivity and ADHD-Like Symptoms

• Restlessness, impulsivity, and difficulty focusing.

Physical hyperactivity can mimic ADHD, but they’re caused by inflammation in the brain, not a developmental disorder. If your typically calm child is suddenly bouncing off the walls and shows a severe onset of hyperactivity, it’s worth investigating.

Akathisia (Inability to Stay Still)

• A relentless urge to move, leading to behaviors like:

-Tapping feet, pacing, or rocking back and forth.

-Crossing and uncrossing legs repetitively.

Akathisia feels like their body is in constant overdrive, as if there’s an internal motor they can’t switch off. This relentless need to move isn’t just a physical experience—it’s deeply tied to the nervous system being stuck in an overstimulated state, unable to find balance.

This is just an “odd” habit or behavior; it’s their body’s response to a dysregulated nervous system that is desperately seeking relief.

Dysgraphia (Handwriting Deterioration)

• Sloppy, hard-to-read handwriting that used to be neat.

You might assume your child is simply ‘too lazy' to write neatly, resulting in illegible scribbles. This isn’t laziness—it’s a direct result of inflammation interfering with fine motor control. Writing becomes an exhausting task that your child may avoid altogether.

Vocal Tics in PANDAS

• Repeating Sounds or Words: This includes repeating phrases, single words, or imitating sounds heard in the environment.
• Throat Clearing and Coughing: Frequent throat clearing, coughing, or making other guttural sounds.
• Unusual Noises: Producing noises like humming, squeaking, squealing, or whistling without a clear reason.
• Yelling or Swearing: Shouting out words or phrases, including inappropriate language, uncontrollably.
• Sniffing and Clicking: Involuntary sniffing or clicking noises made repetitively.

You can just imagine the feelings of embarrassment or frustration kids may have when these vocal tics happen, especially in a school or any social setting. With understanding and support, we can help children navigate these challenges and foster environments where they feel accepted and valued.

These tics often increase during stress or excitement, making it challenging for children to control or suppress them. They are not intentional and often reflect the brain's struggle to regulate motor and vocal pathways.

Why Do These PANDAS Symptoms Happen?

When your child’s immune system mistakenly attacks healthy brain tissue after a strep infection, it creates inflammation in the basal ganglia, a region critical for movement and behavior regulation. This neuroinflammation leads to the tics, hyperactivity, and motor issues you’re seeing. It’s not in their control—it’s their brain waving a big red flag for help.

This neuroinflammation also causes fluctuations in symptom severity, with symptoms potentially worsening suddenly during infections and leading to periods of heightened severity that can last for weeks or even months.

Causes of Tics

One cause of tics is Tourette’s Syndrome. 

Another significant cause is PANDAS syndrome, a pediatric disorder associated with sudden behavioral changes following a strep infection. Tics are often seen in children with PANS and PANDAS, which is an infectious disease and toxin-triggered disorder that produces sudden and dramatic onset of intense psychiatric or cognitive symptoms.

If you suspect PANS/PANDAS, it is best to meet with medical providers to diagnose PANDAS and receive appropriate treatment; otherwise, your child and family may not get the critical care they need.

A clinical diagnosis is determined through established diagnostic criteria that look at medical history, signs, and symptoms. Giving a complete account of your medical history and describing your symptoms in detail is important.

Additional testing for infectious diseases, other infections, toxins, etc. can identify pieces of the puzzle that need to be addressed. There’s also a need to rule out other known neurological or medical disorders.

It is important to note that there is no one test or set of tests that can give a definitive diagnosis. A proper diagnosis can be made with a clinical intake.

How to Help Your Child with PANDAS Symptoms and Tics

1. Treat the Underlying Cause

• Antibiotics: Antibiotic treatment is commonly used to treat PANDAS by addressing the lingering strep infection.
• Anti-inflammatory Therapies: To reduce brain inflammation and restore balance.

2. Support Movement and Motor Control

• Occupational Therapy: Helps rebuild fine motor skills and overcome dysgraphia.
• Physical Therapy: Improves gross motor coordination and helps with hyperactivity or akathisia.
• Cognitive Behavioral Therapy: CBT can help manage tics by teaching children strategies to recognize triggers, reduce stress, and develop alternative responses to suppress or redirect tic behaviors.

3. Calm the Brain with Neurofeedback and PEMF

• Neurofeedback and PEMF Therapy: Non-invasive tools that regulate brain activity and reduce inflammation, calming your child’s overactive nervous system.

4. Create a Supportive Environment

• Establish routines that provide structure and reduce unpredictability.
• Offer calm reassurance during flare-ups, helping your child feel safe while they navigate the storm.

When your child is struggling with tics and movement issues, it’s easy to feel helpless or overwhelmed. But let’s be clear: your child isn’t being difficult, and you didn’t cause this. PANDAS is a medical condition, not a reflection of your parenting.

With the right treatments, therapies, and support, your child can heal and find relief from their symptoms. They are so much more than their tics or behaviors. And with your love and the right interventions, they can get back to being the bright, amazing kid they’ve always been.

To understand more about PANS disease, I invite you to check out my Natural PANS/PANDAS Calm Brain Kit. With this parent kit, you'll gain a clear understanding of what this condition truly is and discover natural, effective solutions to help manage your child's symptoms and support their journey to healing.