77% of PANS children exhibit symptoms of a Separation Anxiety Disorder (T.Murphy et al 2014). The case study by Drs. Navkhare and Kalra, The curious case of the “inseparable child”, highlights “the importance of considering the differential diagnosis of autoimmune neuropsychiatric manifestation of streptococcal infection in a child who develops sudden onset behavioral change including symptoms of separation anxiety or school refusal.”
In this study, “a 10-year-old male child was brought by his parents with a 1-month history of irritability, restlessness, and increased anxiety on separation from parents. These symptoms were abrupt in onset, with the child suddenly refusing to play with his sister and other children in his neighborhood. He began asking his parents to be around him and cried if they did not listen. He insisted that his parents and siblings did not move away from him even for a minute to the point of not allowing them to go to another room. Within 2 days, the behavior increased to such an extent, that he would cry at the thought of separation from his parents and siblings.”
According to the study, “He was started on oral cefixime (100 mg bid) with oral acetaminophen (40 mg/kg) for 10 days. On follow-up after 10 days, parents reported complete remission of his symptoms within 5 days of starting medications.”
To read the case study The curious case of the “inseparable child” from the Indian Journal of Psychiatry by Drs. Navkhare and Kalra, visit http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4181186/.