How do you confidently diagnose a child that you suspect is presenting with PANDAS/PANS? (See lead article for definition.) And if you do make that diagnosis, how should treatment proceed? Child psychiatrist Erica Greenberg sees new cases almost every week. We turned to her for some boots-on-the-ground guidance.

Dr. Greenberg works in the obsessive compulsive disorder (OCD) and related disorders program, and I see both kids with tics and OCD or OCD-related disorders as well as those with symptoms consistent with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) or pediatric acute-onset neuropsychiatric syndrome (PANS). She typically sees two to three new patients a week who fit somewhere in the OCD, tic, or PANDAS spectrum.