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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 one of the major signs of acute rheumatic fever. It is discussed here separately because it 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 in different muscle groups (looks like twitching)
  • 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 are given against streptococci, the bacteria that cause rheumatic fever. The health care provider may prescribe preventive antibiotics (antibiotic prophylaxis).

Supportive care is given as necessary to control symptoms of Sydenham chorea, especially the constant movements. Sedation may be advised in severe cases.



Support Groups:



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:

Gerber MA. Group A streptococcus. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 182.




Review Date: 9/22/2008
Reviewed By: Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
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