2017 Sec 1 Green Book

Z. Farhood et al. / International Journal of Pediatric Otorhinolaryngology 89 (2016) 149 e 153

Table 1 Swedo criteria for diagnosis of PANDAS. Swedo criteria 1 Presence of OCD and/or a tic disorder. 2 Symptom onset between 3 years of age and the beginning of puberty.

3 Episodic clinical course: abrupt symptom onset or exacerbations of OCD/tics. Symptoms usually decrease between episodes or may resolve completely. 4 Association of the exacerbation with evidence of group A b -hemolytic (GABHS) streptococcal infection, i.e., a positive throat culture and/or increased levels of anti- GABHS antibody titers. 5 Association with neurologic abnormalities such as adventitious movements and/or motoric hyperactivity.

3. Results

Table 2 Search methods used in systematic review. Term PANDAS AND (tonsillectomy OR adenotonsil*) (antibiotic* OR penicillin OR augmentin OR cephalosporin* OR azithro*) (intravenous immunoglobulin OR IVIG) (cognitive behavioral therapy) ( fl uoxetine OR fl uvoxamine OR sertraline

The results of our search strategy are shown in Fig. 1 . Thirteen articles were ultimately included in this review. The following sections details the search results by treatment modality.

3.1. Adenotonsillectomy

Six articles regarding tonsillectomy treatments were found [3 e 8] ; all PANDAS patients received tonsillectomy for conditions which met the criteria of the American Academy of Otolaryngology-Head & Neck Surgery [9] . Orvidas & Slattery re- ported two siblings who although responded symptomatically to antibiotic treatment during Group-A Beta-Hemolytic Streptococcus (GABHS) infections, underwent tonsillectomy with resolution of symptoms in one child and improvement in the other 11 months

OR paroxetine OR SSRI OR selective serotonin reuptake inhibitor)

references of full-text included articles were scanned for additional sources. Level of evidence was assessed using the Oxford Centre for Evidence Based Medicine criteria [2] .

Fig. 1. Literature search results.

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