Sydenham chorea

Sydenham chorea is a movement disorder that occurs after infection with specific bacteria called group A streptococcus.

Causes

Sydenham chorea is caused by an infection with bacteria called group A streptococcus. This is the bacteria that causes rheumatic fever (RF) and strep throat. Group A streptococcus bacteria can trigger an immune response that reacts with a part of the brain called the basal ganglia to cause this disorder. The basal ganglia are a set of structures deep in the brain. They help control movement, posture, and speech.

Sydenham chorea is a major sign of acute RF. The person may currently or recently have had the disease. Sydenham chorea may be the only sign of RF in some people.

Sydenham chorea occurs most often in girls before puberty, but may be seen in boys.

Symptoms

Sydenham chorea mainly involves jerky, uncontrollable and purposeless movements of the hands, arms, shoulder, face, legs, and trunk. These movements look like twitches, and disappear during sleep. Other symptoms may include:

• Changes in handwriting
• Loss of fine motor control, especially of the fingers and hands
• Loss of emotional control, with bouts of inappropriate crying or laughing

Symptoms of RF may be present. These may include:

• High fever
• Heart problem
• Joint pain or swelling
• Skin lumps or skin rashes
• Nosebleeds

Exams and Tests

Your health care provider will perform a physical exam. Your provider will ask questions about your symptoms.

If a Group A streptococcus infection is suspected, tests will be done to confirm the infection. These include:

• Throat swab

  Throat swab

  A throat swab culture is a laboratory test that is done to identify germs that may cause infection in the throat. It is most often used to diagnose ...

  Read Article Now Book Mark Article
• Anti-DNAse B blood test

  Anti-DNAse B blood test

  Anti-DNase B is a blood test to look for antibodies to a substance (protein) produced by group A streptococcus. This is the bacteria that cause stre...

  Read Article Now Book Mark Article
• Antistreptolysin O (ASO) blood test

  Antistreptolysin O (ASO) blood test

  Antistreptolysin O (ASO) titer is a blood test to measure antibodies against streptolysin O, a substance produced by group A streptococcus bacteria. ...

  Read Article Now Book Mark Article

Further testing may include:

• Blood tests such as ESR, CBC

  ESR

  ESR stands for erythrocyte sedimentation rate. It is commonly called a "sed rate. "It is a test that indirectly measures the level of certain protei...

  Read Article Now Book Mark Article

  CBC

  A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...

  Read Article Now Book Mark Article
• MRI or CT scan of the brain

  MRI

  A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...

  Read Article Now Book Mark Article

  CT scan of the brain

  A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.

  Read Article Now Book Mark Article

Treatment

Antibiotics are used to kill the Group A streptococcus bacteria. Your provider may also prescribe antibiotics to prevent future RF infections. This is called preventive antibiotics, or antibiotic prophylaxis.

Severe movement or emotional symptoms may need to be treated with medicines.

Outlook (Prognosis)

Sydenham chorea usually clears up in a few months. In rare cases, an unusual form of Sydenham chorea may begin later in life.

Possible Complications

No complications are expected.

When to Contact a Medical Professional

Contact your provider if your child develops uncontrollable or jerky movements, especially if your child has recently had a sore throat.

Prevention

Pay careful attention to your children's complaints of sore throats and get early treatment to prevent acute RF. If there is a family history of RF, be watchful, because your children may be more likely to develop this infection.