Prevalence of Neurological Soft Signs at Presentation in Pediatric Acute-Onset Neuropsychiatric Syndrome

This was a retrospective study of 135 children conducted at the Stanford Children’s Immune Behavioral Health (IBH) seen between 2014 and 2020. The goal of this study was to characterize the prevalence and predictors of neurological soft signs which may reflect basal ganglia dysfunction (NSS-BG) at clinical presentation. We hypothesized a high prevalence of NSS-BG among patients with PANS and that patients who presented with more NSS-BG would exhibit more severe disease states and experience more PANS symptoms. The NSS-BG evaluation included: 1) glabellar tap reflex, 2) abnormal tongue movements, 3) milkmaid’s grip, 4) choreiform movements, 5) spooning, and 6) overflow movements. Thus, a patient could present with a minimum of zero or a maximum of six NSS-BG.

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