One thing that has been very reliable in detecting an oncoming PANDAS flare up in my daughter is simply the look in her eyes. I tried to capture this 'look' in a photograph since I have been looking for a way to best describe this to her pediatrician and other parents. It was when I was cropping the image that I realized just how similar her "PANDAS" eyes are to those of a real panda bear. Droopy, dark circles, and abnormal pupils. Both sets of eyes make me want to give them each a big Mama Bear hug.
Panda image obtained from fellow blogger....http://chengxiao123456.blog.com/page/4/