A brief provider companion for primary care clinicians seeing sudden-onset neuropsychiatric symptoms in children, including PANS and PANDAS. Covers hallmark features, differential diagnosis, urgent red flags, reasonable initial workup, supportive care, and language that preserves family alliance.
When a Child Changes Overnight: PCP Companion is designed for primary care clinicians who may not specialize in PANS/PANDAS but want to respond thoughtfully when a child presents with abrupt OCD, restrictive eating, tics, severe anxiety, rage, urinary changes, cognitive decline, regression, or other sudden neuropsychiatric symptoms.
Want the family-facing version too? This provider companion pairs with the When a Child Changes Overnight parent guide, which helps families track symptoms, organize timelines, and prepare for medical conversations.
PCP COMPANION · PEDIATRIC NEUROPSYCHIATRIC CARE
This brief provider companion helps primary care clinicians recognize the clinical picture, keep the differential open, identify urgent red flags, consider a reasonable initial workup, and preserve collaboration with families.
Recognizing the Presentation
Summarizes hallmark features, including abrupt onset of OCD or severely restrictive eating, new or worsened tics, separation anxiety, rage episodes, sleep disruption, urinary changes, cognitive decline, sensory changes, and regression.
Differential to Keep Open
Includes conditions to consider such as autoimmune encephalitis, Sydenham chorea, primary OCD/Tourette syndrome, ARFID or eating disorders, trauma-related symptoms, medication effects, thyroid dysfunction, nutritional deficiencies, and seizure disorders.
Urgent Red Flags
Highlights when escalation is needed, including refusal of intake or dehydration, suicidal ideation, hallucinations or florid psychosis, focal neurologic signs, seizures, severe agitation, or fever with neurologic findings.
Reasonable Initial Workup
Outlines history, exam considerations, initial labs, and referrals that can support coordinated care without requiring premature diagnostic certainty.
Alliance-Preserving Language
Offers a balanced way to validate family concerns while staying grounded in evidence, uncertainty, and coordinated supportive care.
This companion is an educational provider support tool and is not a substitute for clinical judgment, diagnosis, medical evaluation, emergency care, specialty consultation, or individualized treatment planning. Always individualize care and escalate urgent symptoms as clinically indicated.