Sydenham chorea

• Alternative Names

  St. Vitus dance

• Causes, incidence, and risk factors

  Sydenham chorea is one of the major signs of acute rheumatic fever. It is discussed here separately because it may be the only sign of rheumatic fever in some patients.

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

• Symptoms
  • Changes in handwriting
  • Jerky, uncontrollable, and purposeless movements in different muscle groups (looks like twitching)
  • Loss of fine motor control, especially of the fingers and hands
  • Loss of emotional control, with bouts of inappropriate crying or laughing
  • Symptoms of rheumatic fever (see acute rheumatic fever)
• Signs and tests

  There may be a history of sore throat for several weeks before Sydenham chorea.

  Blood tests that may show signs of rheumatic fever include erythrocyte sedimentation rate (ESR).

  Different blood tests may be done to identify whether the child may have a strep infection.

• Treatment

  Antibiotics are given against streptococci, the bacteria that cause rheumatic fever. The health care provider may prescribe preventive antibiotics (antibiotic prophylaxis).

  Supportive care is given as necessary to control symptoms of Sydenham chorea, especially the constant movements. Sedation may be advised in severe cases.

• Expectations (prognosis)

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

• Complications

  No complications are expected.

• Calling your health care provider

  Call your health care provider if your child develops uncontrollable or jerky movements, especially if the child has recently had a sore throat.

• Prevention

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

• References

  Gerber MA. Group A streptococcus. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 182.

Review Date: 9/22/2008

Reviewed By: Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.