Sydenham’s Chorea: Symptoms, Causes & Treatment
Table of Contents
Introduction to Sydenham’s Chorea
Sydenham’s chorea, also known as St. Vitus dance or rheumatic chorea, is a rare neurological disorder that primarily affects children. This autoimmune disease is characterized by rapid, irregular, and uncontrollable movements of the face, arms, and legs. Sydenham’s chorea is a complication of rheumatic fever, which is caused by an untreated infection with Group A beta-hemolytic Streptococcus bacteria.
Causes of Sydenham’s Chorea
Sydenham’s chorea is caused by an autoimmune reaction that occurs following an infection with Group A beta-hemolytic Streptococcus (Strep A) bacteria. This infection, commonly known as strep throat, triggers the body’s immune system to produce antibodies that mistakenly attack healthy tissues in the brain, particularly the basal ganglia, which control movement and coordination.
Symptoms of Sydenham’s Chorea
The primary symptom of Sydenham’s chorea is the presence of involuntary, rapid, and irregular movements, often described as dance-like or fidgety. These abnormal movements can affect the face, arms, legs, and trunk. Other symptoms may include:
- Muscle weakness and poor coordination
- Difficulty with fine motor tasks, such as writing or buttoning clothes
- Slurred speech and trouble swallowing
- Emotional instability, including irritability, mood swings, and outbursts of crying or laughter
Diagnosis of Sydenham’s Chorea
Diagnosing Sydenham’s chorea involves a combination of clinical examination, medical history, and laboratory tests. A neurologist will assess the child’s symptoms and look for signs of involuntary movements and muscle weakness. Blood tests, such as anti-streptolysin O (ASO) titer and anti-DNase B, can help determine if there has been a recent Strep A infection. In some cases, brain imaging studies like MRI may be performed to rule out other neurological conditions.
Treatment for Sydenham’s Chorea
Treatment for Sydenham’s chorea focuses on managing symptoms and addressing the underlying Strep A infection. Antibiotics, such as penicillin or erythromycin, are prescribed to eliminate the bacterial infection and prevent recurrences. Anti-inflammatory medications, like corticosteroids or intravenous immuno globulin (IVIG), may be used to reduce inflammation in the brain. In severe cases, neuroleptics or sedatives can help control involuntary movements. Physical therapy and occupational therapy may be recommended to improve muscle control and coordination.
Prognosis and Complications
The prognosis for children with Sydenham’s chorea is generally favorable, with most cases resolving within several months to a year. However, some children may experience recurrent episodes or persistent neurological symptoms. Complications of Sydenham’s chorea can include:
- Difficulty with daily activities and schoolwork
- Social and emotional challenges related to the visible symptoms
- Rarely, progression to more severe forms of chorea or other movement disorders
Prevention of Sydenham’s Chorea
Preventing Sydenham’s chorea involves prompt diagnosis and treatment of Strep A infections. Children who have had rheumatic fever or Sydenham’s chorea may require long-term antibiotic prophylaxis to prevent future Strep A infections and recurrences of the disorder. Regular follow-up with a healthcare provider is essential to monitor the child’s progress and adjust treatment as needed.
