I agree with the previous posters. I think lyme can cause PANS, but I highly doubt it could be the ONLY cause. I look at it as 1 factor in the snowball that hit my son's immune system. I like the analogy (LLM's, I think?) of peeling back the layers of an onion - PANS, lyme, mycoplasma, other co-infections, pyroluria, methylation issues, mold, ??? I believe that there have to be many factors that snowballed together to create this nightmare. I don't think it's exactly the same for everyone, but there would be similarities, hence the high number of us PANDAS folks who have discovered lyme. That must be 1 common factor, but certainly not the only factor, and not a required factor. There are lots of other infections that can cause similar problems. Just my 2 cents...