| Sydenham's chorea is a neurologic movement | | | | developing this new set of symptoms. They may |
| disorder characterized by irregular, abrupt, relatively | | | | also have joint pains without swelling, a condition |
| rapid involuntary movements (i.e., chorea) of muscles | | | | known as arthralgia. Sydenham's chorea will appear as |
| of the face, neck, trunk, and arms and legs (limbs). | | | | uncontrollable twitching or jerking of any part of the |
| Additional findings often include diminished muscle | | | | body that is worse when trying to repress it but |
| tone (hypotonia), muscle weakness, and emotional | | | | disappears with sleep. |
| and behavioral disturbances, particularly | | | | Psychological Symptoms |
| obsessive-compulsive behaviors. Sydenham's chorea | | | | Psychological symptoms precede chorea and may be |
| most frequently occurs in children or adolescents | | | | relapsing and remitting. They include: |
| between the ages of 5 to 15 following acute | | | | · Emotional lability |
| rheumatic fever (ARF). ARF is an inflammatory | | | | · An obsessive trait |
| disease that develops subsequent to throat infection | | | | · Cognitive defects |
| with certain strains of streptococcal bacteria (i.e., | | | | · Personality change |
| group A beta-hemolytic streptococci). | | | | Diagnosis |
| Chorea is an irregular, rapid, uncontrolled, involuntary, | | | | Because rheumatic fever is such a damaging disease, |
| excessive movement that seems to move randomly | | | | a complete evaluation should be done whenever it is |
| from one part of the body to another. The affected | | | | suspected. This includes cultures for streptococci, |
| child often appears fidgety or restless and unable to | | | | blood tests, and usually an electrocardiogram |
| sit still. The word "chorea" comes from the Greek | | | | (heartbeat mapping to detect abnormalities). |
| word for dance. The jerky movements of the feet | | | | Treatment |
| or hands are often similar to dancing or piano playing. | | | | There is no specific treatment for SD. For people |
| When chorea is severe, the movements may cause | | | | with the mildest form, bed rest during the period of |
| motion of the arms or legs that results in throwing | | | | active movements is sufficient. When the severity of |
| whatever is in the hand or falling to the ground. | | | | movements interferes with rest, sedative drugs, such |
| Walking may become bizarre, with inserted excessive | | | | as barbiturates or benzodiazepines, may be needed. |
| postures and leg movements. | | | | Antiepileptic medications, such as valproic acid, are |
| Causes and Symptoms | | | | often prescribed. Doctors also recommend that |
| Sydenham's is caused by certain types of | | | | children who have had SD take penicillin over the |
| streptococci called Group A beta-hemolytic | | | | course of the next 10 years to prevent additional |
| streptococci or GAS bacteria. In general, streptococci | | | | manifestations of rheumatic fever. |
| are spherical-shaped anaerobic bacteria that occur in | | | | Anti-inflammatory medications such as aspirin or |
| pairs or chains. GAS bacteria belong to a subcategory | | | | corticosteroids reduce inflammation to help manage |
| known as pyogenic streptococci, which means that | | | | acute rheumatic fever. |
| the infections they cause produce pus. These | | | | People who test positive for strep throat should also |
| particular germs seem to be able to create an | | | | be treated with antibiotics. You may have to take |
| immune response that attacks the body's own | | | | low doses of antibiotics (such as penicillin, sulfadiazine, |
| tissues along with the germs. Those tissues are | | | | or erythromycin) over the long term to prevent the |
| joints, heart valves, skin, and brain. | | | | disease from returning. |
| Many patients suffer from strep throat, just before | | | | |