Were do you live and who is your PED- this is very important!!! Not all believe it exists- I just spoke with the top researcher this week and there is so much ground breaking work in this area. It sure sounds like PANDAS to me- I sent you a PM the other day too. Seriously call me- I have been through this and you need support, especially while exploring. If your PED says no- don't rule it out- he may not know anything about it. If it is his first exacerbation he would qualify for research trials. Check out the ACN PANDAS and PITANDS forum. Many parents have to travel to get to the right Dr.
Regarding tics- upswing after tics is a high indicator and strep often can go undiagnosed. Also if he is around someone with strep he can activate or now that his started even a virus can initiate the tics.
Good luck!!!
