Sydenham's Chorea
Sydenham's Chorea is a neurological disorder of the basal ganglia first identified in medical literature in 1686 by Thomas Sydenham. This disorder has also been called acute chorea, rheumatic chorea, chorea minor, infectious chorea, and St. Vitus dance. The name St. Vitus dance is derived from the Middle Ages when people who had this disease gathered in the chapels of St. Vitus in belief that this Catholic patron saint of dancing had miraculous curative powers.1,2 This type of chorea is a movement disorder as other types of chorea are. Sydenham's chorea is characterized by involuntary, irregular, purposeless movements of the face (including the tongue), neck, trunk, and extremities. The choreic movements usually begin gradually and progressively worsen over weeks to months. The movements are absent when the person is asleep and resume when they wake up. The true etiology of Sydenham's chorea is not known but it is considered to be triggered by a group A beta-hemolytic streptococci infection.
Sydenham Under Snow
Sydenham station LO NR sign, London
Sydenham houseSydenham's chorea is rare today due to the common use of antibiotics to treat strep infections.3 The initial illness is usually a strep pharyngitis followed by a sudden onset of rheumatic fever within 1 to 5 weeks, and possibly up to three months before the appearance of chorea. The chorea occurs in about 25-33% of patients with rheumatic fever.3,4 Sydenham's chorea usually resolves spontaneously in weeks to months, occasionally years. Relapses can occur after months to years in 20-33% of the cases.5,6 The mechanism for the development of acute rheumatic fever (ARF) is also unclear. Some evidence suggests that ARF may be an abnormal immune reaction and that Sydenham's chorea is an autoimmune response. Sydenham's chorea most often occurs in children ages 3-15 and in pregnant women after acute rheumatic fever. It is very rare anytime after adolescence...