Cognitive Issues

Children with acute PANDAS have an enlarged caudate nucleus, globus pallidus, and putamen in the basal ganglia (Da Rocha et al. 2008). In an analysis of the basal ganglia and related structures of 34 children with PANDAS compared with 82 healthy control subjects, Giedd et al. (2000) found a markedly enlarged caudate, putamen, and globus pallidus. However, they also found that the sizes of the thalamus and total cerebrum were similar in both groups (Giedd et al. 2000). The basal ganglia and related structures that are enlarged in children with PANDAS are also enlarged in children with Syden-ham's chorea and OCD without PANDAS (Giedd et al. 2000). Enlargement of the basal ganglia and related structures is correlated to times when the child is experiencing acute PANDAS symptoms. Treatment with antibiotics for GABHS decreases the size of the basal ganglia in children with PANDAS (Da Rocha et al. 2008). When the child's symptoms are in remission/nonacute phase, the basal ganglia and associated structures return to normal size (Da Rocha et al. 2008).

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