PANS can be trigger by chronic Lyme and co-infections. Are you still treating for Lyme? Did you treat for any other co-infections?
We have three children, all gestational Lyme and have been treating ongoing for last seven years. Our older son was a clear PANS child. Strep, MMR and virus all within three week period woke up a different child at 5 1/2 years old. Younger twins had ASD and Asperger's presentation at 2 1/2 years old.
They are now 10, 10 and 13 years old. You would never know of their prior diagnoses. All are living normal lives. Even our DD's learning disabilities have reversed. Eye sight improved, etc. etc. etc.
They have had tons of intervention but are well. I would encourage you to revisit the chronic Lyme et al component to resolve PANS