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My DS who is almost 14 has suddenly developed a mild facial tic (about a month ago). Tics were never part of his PANS presentation. It is not debilitating, and hardly noticeable. He is currently on prophylactic augmentin, but no other medicines. We increased antibiotics for 10 days with no change. We also got his blood tested, and all levels are normal, and strep titers are at an all-time low. Background: Around October 2010, DS developed sudden OCD. In April of 2011, he had not improved with CBT and EPRT - so medication was recommended. Almost as an afterthought before writing the prescription, his psychiatrist said, "And we've ruled out strep, right?" DS got a rapid swab that day - which was positive - and our lives were suddenly changed forever. We tried antibiotics, saw some improvement, but the improvement did not last. Ultimately we found our way to Dr. K, who recommended IVIG. Our treating pediatrician ordered the IVIG at a local hospital using Dr. K's protocol. It seemed to work for about 8 months. He then relapsed in May 2012 due to a pneumonia infection. He got a second IVIG in Sept 2012 (this time administered by Dr. K). Though the second IVIG took longer to "work," since about March of 2013, DS has been 90% symptom free. He is well into puberty (voice lower, and he is 6 feet tall). Questions: So what do we do about this tic? He does not notice it, and it is most pronounced at night. He has no other PANS symptoms. Is it worth doing anything when it still almost completely OK? Do you think this is an indicator of a different infection? Thank you for any guidance you can offer!