Michael is a high school student with PANDAS who I have been treating for the last several months. He developed the condition at the age of 8 after a bout of strep throat that was treated with antibiotics. The strep kept on reoccurring and Michael began exhibiting odd behaviors. He would wiggle or shake his body and make stepping patterns with his feet or tapping patterns with his fingers. Then he started with various tics that presented like slurping and sniffing.