PANS & PANDAS Treatment in Brookline, MA
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PANS and PANDAS are conditions in which children experience a sudden and significant change in behavior, mood, or functioning, often following an infection or immune response. Families may notice abrupt onset of anxiety, obsessive behaviors, emotional changes, or a rapid decline in daily skills.
Dr. Annabel Kuhn is a board-certified psychiatrist who completed her residency at Harvard and her fellowship at Boston Children's Hospital. She has worked with the Massachusetts General Hospital Pediatric Neuropsychiatry and Immunology Program and provides expert evaluation and treatment of PANS and PANDAS.
Because symptoms can develop quickly and may overlap with other medical or psychiatric conditions, careful evaluation is needed. Dr. Kuhn has also written an article with more information on PANS and PANDAS.
Every family begins with a brief phone conversation before scheduling an evaluation.
Where Dr. Kuhn Fits In
Dr. Kuhn does
- Provide comprehensive psychiatric evaluation integrated with medical history and relevant laboratory data
- Assess the timing of symptom onset relative to infection or immune events
- Treat OCD, anxiety, tics, and related neuropsychiatric symptoms
- Work closely with your child's pediatrician on coordinated, conservative decision-making
- Provide evidence-based psychotherapy and psychiatric medication management
Dr. Kuhn does not
- Direct the medical or immunological workup
- Prescribe antibiotics, IVIG, or immunotherapy
- Replace your child's pediatrician or immunologist
- Provide inpatient or emergency care
Understanding PANS & PANDAS
PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections) and PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) are conditions in which infections trigger a sudden and dramatic onset of neuropsychiatric symptoms in children. While PANDAS is specifically associated with streptococcal infections, PANS encompasses a broader range of infectious triggers.
A hallmark feature of these conditions is the rapid onset of symptoms, often going from nonexistent to severe over the course of days to a week. This is vastly different from typical OCD and other psychiatric disorders, which tend to have a more gradual onset. Accurate diagnosis requires careful attention to the temporal relationship between infection and symptom emergence.
PANS and PANDAS sit within the broader category of autoimmune and inflammatory conditions that Dr. Kuhn works with.
Signs & Symptoms
Dr. Kuhn's Approach to PANS & PANDAS
The initial evaluation takes about two hours and happens in two parts. The first is with the parents or caregivers, before Dr. Kuhn meets the child, so the complete history can be shared and concerns can be raised that parents may not want to discuss in front of their child. With PANS and PANDAS that history matters enormously, since the timeline of infection, symptom onset, and prior treatment is often the diagnostic information.
The second part is with the child. Dr. Kuhn wants to understand the child as an individual, and she also pays attention to how the child and parents communicate and relate to one another, because family dynamics are essential to understanding a child's perspective.
Care is highly individualized and emphasizes interventions supported by the best available scientific evidence. Treatment may include evidence-based psychotherapy, such as cognitive behavioral therapy, as well as judicious medication management to address OCD and related neuropsychiatric symptoms when clinically appropriate.
Dr. Kuhn works closely with your child's pediatrician or primary care clinician to ensure coordinated, conservative, and medically sound decision-making, including thoughtful consideration of antibiotic treatment when indicated. Her limited patient panel means she has availability to see children as often as the situation requires, which matters during acute flares.
Educational Resource
Dr. Kuhn contributed to the CME article for Episode 147 of the Psychiatry & Psychotherapy Podcast, featuring experts from the MGH PANDAS Clinic discussing diagnosis, treatment, and the latest research on PANS and PANDAS.
Who Dr. Kuhn Coordinates With
PANS and PANDAS care rarely sits with one clinician. With your consent, Dr. Kuhn communicates directly with the people managing the medical side.
Frequently Asked Questions
What is the difference between PANS and PANDAS?
PANDAS specifically refers to cases triggered by streptococcal infections, while PANS is a broader term that includes neuropsychiatric symptoms triggered by various infections or other inflammatory processes. Both share the hallmark feature of sudden, dramatic symptom onset.
How is PANS/PANDAS diagnosed?
Diagnosis requires a comprehensive evaluation including psychiatric assessment, detailed medical history, and review of laboratory data. Dr. Kuhn carefully interprets findings in the context of symptom onset and clinical course, looking specifically for the rapid onset that distinguishes these conditions from typical OCD.
Does Dr. Kuhn prescribe antibiotics for PANS/PANDAS?
No. Dr. Kuhn is a psychiatrist and does not prescribe antibiotics, IVIG, or immunotherapy, and does not direct the medical workup. She works closely with your child's pediatrician or primary care clinician to coordinate care, including thoughtful consideration of antibiotic treatment when indicated, with those decisions made by the medical team.
What treatments does Dr. Kuhn provide?
Treatment may include evidence-based psychotherapy such as cognitive behavioral therapy, as well as medication management for OCD and related neuropsychiatric symptoms when clinically appropriate. Care is highly individualized based on each patient's presentation.
What should we expect at the first appointment?
Every family begins with a brief ten-minute introductory call with a parent or caregiver before an evaluation is scheduled. The evaluation itself takes about two hours in two parts, starting with the parents or caregivers and then the child, and includes careful review of medical history and any available laboratory data. Visit our Payment & Fees page for details on appointment types and pricing.
Is telehealth available for PANS/PANDAS treatment?
Yes. Dr. Kuhn offers telehealth appointments for families throughout Massachusetts. Initial evaluations for complex cases may benefit from in-person assessment.
What areas does Dr. Kuhn serve?
Dr. Kuhn sees patients in person in Brookline and the Greater Boston area, including Cambridge, Somerville, Newton, and surrounding communities. Telehealth appointments are available for patients throughout Massachusetts.
Our Location
Brookline, MA 02446
Virtual appointments available throughout Massachusetts
Located on Beacon Street near Coolidge Corner, one mile from Boston Children's Hospital and the Longwood Medical Area.
Start With a 10-Minute Introductory Call
Before scheduling an evaluation, Dr. Kuhn speaks with a parent or caregiver by phone for about ten minutes. It is a chance to describe what your child needs, ask about her approach, and decide together whether this practice is the right fit.
Request a 10-Minute Introductory Call