tics and flare ups

[momwithtwins]

Does anyone know if reoccuring episodes ALWAYS include a tic (in our case)with the behavioral changes? I have a 4 year old who has a tic (which made us recognize there was a problem) and exaggerated behaviorial issues. But recognizing a future PANDAS episode based only on behavioral changes is really hard...especially with a 4 year old. So, does the tic typically accompany the other symptoms?

 

Worried I won't recognize a flare up.

[swim]

For our son, recurring epidoses are always noted by an increase in tics but it seems all kids are different. Our son's symptoms have always been (for the past 7 years) more tic related with a lesser level of OCD issues. I think you will find others on this forum that have mostly OCD issues and few tic problems.