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Sydenham chorea

Definition

Sydenham chorea is a movement disorder that occurs with rheumatic fever.

Alternative Names

St. Vitus dance

Causes, incidence, and risk factors

Sydenham chorea is a major sign of acute rheumatic fever. The person may currently or recently have had the disease. Sydenham chorea may be the only sign of rheumatic fever in some patients.

Sydenham chorea occurs most often in girls before puberty, but may be seen in boys.

Symptoms

  • Changes in handwriting
  • Jerky, uncontrollable, and purposeless movements that look like twitches; the abnormal movements disappear during sleep
  • Loss of fine motor control, especially of the fingers and hands
  • Loss of emotional control, with bouts of inappropriate crying or laughing
  • Symptoms of rheumatic fever (See: Acute rheumatic fever)

Signs and tests

There may be a history of sore throat for several weeks before Sydenham chorea.

Blood tests that may show signs of rheumatic fever include erythrocyte sedimentation rate (ESR).

Different blood tests may be done to identify whether the child may have a strep infection.

Treatment

Antibiotics used to kill the bacteria that cause rheumatic fever. The doctor may also prescribe antibiotics to prevent future rheumatic fever infections. This is called preventive antibiotics, or antibiotic prophylaxis.

Symptoms will be treated as appropriate. Sedation may be needed in severe cases.

Expectations (prognosis)

Sydenham chorea usually clears up in a few months. In rare cases, an unusual form of Sydenham chorea may begin later in life.

Complications

No complications are expected.

Calling your health care provider

Call your health care provider if your child develops uncontrollable or jerky movements, especially if the child has recently had a sore throat.

Prevention

Pay careful attention to children's complaints of sore throats and get early treatment to prevent acute rheumatic fever. If there is a strong family history of rheumatic fever, be especially watchful, because your children may be more likely to develop this infection.

References

Jankovic J. Movement disorders. In: Daroff RB, Fenichel GM,Jankovic J, Mazziotta JC, eds. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 71.

Lang AE. Other movement disorders. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 417.

Low DE. Nonpneumococcal streptococcal infections, rheumatic fever. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 298.


Review Date: 8/28/2012
Reviewed By: Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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