Cocuzza Salvatore, Maniaci Antonino, La Mantia Ignazio, Nocera Francesco, Caruso Daniela, Caruso Sebastiano, Iannella Giannicola, Vicini Claudio, Privitera Elio, Lechien Jerome Rene, Pavone Piero
Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section, University of Catania, 95123 Catania, Italy.
Unit of Clinical Pediatrics, A.O.U. "Policlinico", P.O. "G. Rodolico", University of Catania, 95123 Catania, Italy.
Children (Basel). 2022 Jan 26;9(2):155. doi: 10.3390/children9020155.
Several treatment options have been proposed for pediatric acute-onset neuropsychiatric syndrome/pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANS/PANDAS). Still, no clear therapeutic protocol has been recognized to prevent these neuropsychiatric diseases. The study aims to report on the literature evidence and different treatment strategies related to these disorders.
We analyzed the last 20 years' English language literature and performed a comprehensive review of the PANS/PANDAS treatment, including studies reporting OCD outcomes post-treatment follow-up.
We covered 11 articles in our systematic literature review for a total of 473 patients, of which four studies included 129 surgical subjects and seven papers with 326 medically treated patients. Pooled outcomes analysis, surgical and medical treatment reported an OCD reduction, but no statistical significance was obtained ( < 0.05 for both).
Surgical therapy in selected patients can lead to promising results, although further evidence is needed. On the other hand, the role of medical therapy remains controversial, often due to the lack of univocal curative protocols and variable responses depending on the drug used and the timing of administration. Therefore, further investigations are necessary to clarify the most appropriate therapeutic procedure.
针对小儿急性起病神经精神综合征/与链球菌感染相关的小儿自身免疫性神经精神障碍（PANS/PANDAS），已经提出了几种治疗方案。然而，尚未有明确的治疗方案被认可用于预防这些神经精神疾病。本研究旨在报告与这些疾病相关的文献证据和不同治疗策略。
我们分析了过去20年的英文文献，并对PANS/PANDAS的治疗进行了全面综述，包括报告治疗后随访强迫症结果的研究。
我们在系统文献综述中涵盖了11篇文章，共473例患者，其中四项研究包括129例手术受试者，七篇论文涉及326例接受药物治疗的患者。汇总结果分析显示，手术和药物治疗均报告强迫症有所减轻，但未获得统计学意义（两者均P<0.05）。
尽管需要进一步的证据，但对选定患者进行手术治疗可取得有前景的结果。另一方面，药物治疗的作用仍存在争议，这通常是由于缺乏明确的治愈方案，以及取决于所用药物和给药时间的可变反应。因此，有必要进行进一步的研究以阐明最合适的治疗程序。
