02/17/2026
Choreiform movements can be a helpful clinical clue during a PANS/PANDAS flare.
In the office, we assess this by having a child stand with arms extended and eyes closed, watching for small, involuntary “piano-playing” finger movements.
When present, this can suggest inflammation affecting the basal ganglia, helping us understand that symptoms are driven by immune activation.
Not every child with PANS/PANDAS will show this sign, and its absence does not rule out a flare. It’s simply one tool we use to better understand what may be driving symptoms.