St. Vitus dance; Chorea minor; Rheumatic chorea; Rheumatic fever - Sydenham chorea; Strep throat - Sydenham chorea; Streptococcal - Sydenham chorea; Streptococcus - Sydenham chorea
Sydenham chorea is a movement disorder that occurs after infection with specific bacteria called group A streptococcus.
Sydenham chorea is caused by an infection with bacteria called group A streptococcus. This is the bacteria that cause rheumatic fever (RF) and strep throat. Group A streptococcus bacteria can react 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.
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:
Symptoms of RF may be present. These may include:
The health care provider will perform a physical exam. The 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:
Further testing may include:
Antibiotics are used to kill the Group A streptococcus bacteria. The 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.
Sydenham chorea usually clears up in a few months. In rare cases, an unusual form of Sydenham chorea may begin later in life.
No complications are expected.
Contact your provider if your child develops uncontrollable or jerky movements, especially if the child has recently had a sore throat.
Pay careful attention to 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.
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Review Date: 5/2/2022
Reviewed By: Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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