Sydenham's Chorea

Sydenham chorea is a type of chorea that is caused by the streptococcal bacteria. Chorea is a type of movement that results when nerve cells deteriorate in the brain.The condition is marked by involuntary movements that gradually become severe and affect all motor activities.

What is going on in the body?

Sydenham chorea is caused by the streptococcal bacteria, and often follows a bout of rheumatic fever. Nerve cells in the brain deteriorate, producing sudden, involuntary movements that are jerky and purposeless. These movements gradually become more severe and affect all movement. There may also be difficulty with fine motor movement, especially with handwriting.

What are the signs and symptoms of the condition?

Symptoms of Sydenham chorea appear gradually. At first the person may appear fidgety or nervous and may have difficulty with fine motor movements such as writing. As symptoms progress, the person may appear clumsy and drop things or fall frequently. Eventually, the uncontrollable, jerky, and irregular movements develop. Varying degrees of speech impairment are also seen as well as emotional instability.

What are the causes and risks of the condition?

Rheumatic fever is a bacterial infection caused by the streptococcal organism. This germ also causes strep throat. Sydenham chorea is a disorder that occurs weeks after the body is infected by these bacteria. Not everyone who develops rheumatic fever will develop Sydenham chorea. It occurs chiefly between the ages of 5 and 15 or during pregnancy.

What can be done to prevent the condition?

Most cases of Sydenham chorea can be prevented by early diagnosis and prompt treatment of streptococcal infections, such as strep throat.

How is the condition diagnosed?

The first step in diagnosing Sydenham chorea is a complete medical history and physical examination. A throat culture can be done to see if a streptococcal infection is present. Blood samples may also be drawn for testing.

What are the long-term effects of the condition?

Sydenham chorea usually has no long term effects, and generally clears up on its own. It may take several weeks to 3 months for this chorea to improve. This condition occasionally lasts 6 to 12 months.

What are the risks to others?

Sydenham chorea itself is not contagious. However, the streptococcal infection that caused the infection is contagious.

What are the treatments for the condition?

Antibiotics are given to treat the streptococcal infection, if it is still present. Sedatives are used on some occasions for the chorea. When movements are severe, a benzodiazepine or antipsychotic medication may be used to control the movements.

What are the side effects of the treatments?

Sedatives can cause fatigue and drowsiness. Antibiotics can cause stomach upset and allergic reactions.

What happens after treatment for the condition?

Sydenham chorea usually goes away on its own with no long term effects. A person with rheumatic fever, however, will need lifelong monitoring.

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare provider.