hi 3beans

when you say your nephew had a strep test...was this just a throat culture or was this the comprehensive blood titration (ASO) to detect any possible strep antibodies that is done to dx PANDAS. For PITANDS, a viral profile is run to determine if any other viral agents are present, most often with Epstein Barr virus being the culprit

Sudden onset of OCD, motor and vocal tics is frequently a result of PANDAS or PITANDS

Then docotrs who are knowledgable in this area are sadly still few and far between, but are growing

You may also want to recommend that he be evaluated by a DAN doctor as they are really up on most of this. Although they specialise in autism, yet they do a lot of work with kids who have all kinds of neuro stuff, and with Aspergers having been mentioned...a DAN doctor really may be the way to go

Here is a helpful thread at Latitudes for finding medical help, including a directory of DAN docs

http://www.latitudes.org/forums/index.php?showtopic=565

HTH