Sydenham’s chorea – Characteristics

SC is characterised by the acute onset (sometimes a few hours) of motor symptoms, classically chorea, usually affecting all limbs. Other motor symptoms include facial grimacing, hypotonia, loss of fine motor control and a gait disturbance.

SC is characterised by the acute onset (sometimes a few hours) of motor symptoms, classically chorea, usually affecting all limbs. Other motor symptoms include facial grimacing, hypotonia, loss of fine motor control and a gait disturbance. Fifty percent of patients with acute SC spontaneously recover after 2 to 6 months whilst mild or moderate chorea or other motor symptoms can persist for up to and over 2 years in some cases (for example a patient in the UK who has suffered the illness since 1999). Sydenham's is also associated with psychiatric symptoms with obsessive compulsive disorder being the most frequent manifestation. The PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections) syndrome is similar, but is not characterized by Sydenham's motor dysfunction, but presenting with tics and/or with psychological components (OCD) and much sooner, days to week after GABHS infection rather than 6–9 months. It is related to other illnesses such as Lupus and Tourette's.

Movements cease during sleep, and the disease usually resolves after several months. It is associated with post-streptococcal rheumatic fever, pregnancy, hyperthyroidism, and systemic lupus erythematosus.

Neurologic symptoms of SC include behavior change, dysarthria, gait change, loss of fine and gross motor control with resultant deterioration of handwriting, headache, slowed cognition, facial grimacing, fidgetiness and hypotonia. Nonneurologic manifestations of ARF are carditis, arthritis, erythema marginatum, and subcutaneous nodules.


Adapted from the Wikipedia article Sydenham's chorea, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki








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