Abstract

Objective: The Sydenham’s chorea, which is an autoimmune and hyperkinetic movement disorder seen following pharyngitis caused by group A streptococci, is the neurological manifestation of acute rheumatoid fever. This study aims to present the demographical and clinical features in addition to patient management and outcomes in patients diagnosed with Sydenham’s chorea.

Material and Methods: Thirty-three children and adolescents who were admitted to the Ankara Education and Research Hospital pediatric neurology clinic between September 2016 and September 2019 and were diagnosed with Sydenham’s chorea were included in the study. Demographic, clinical and laboratory data, treatments and responses to treatments along with outcomes were evaluated in a retrospective and cross sectional manner.

Results: The average age of the patients was 119,6±29,2 months and 24,2% were male. In 30 (90,9%) of the male patients, valvulitis as reported by echocardiography accompanied Sydenham’s chorea. Hemichorea was present in 11 (30%) patients while chorea was more prominent in the extremities in 12 patients, in the trunk in 8 patients and in the face in 1 patient. Antistreptolysin-O titers were elevated in 28 (84%) patients. Twenty-seven (81,8%) patients were given haloperidol, 3 (9%) patients were given carbamazepine and 2 (%6) patients were given sodium valproate for an average of 6,8±1,1 months. Clinical remission was achieved in 6,9±1,2 months. The only adverse effect observed was parkinsonism caused by haloperidol prescribed for acute symptomatic treatment. The patients were followed up for 9,6±4,2 months after the symptoms had subsided and no recurrence was observed.

Discussion: Sydenham’s chorea is one of the major criteria for acute rheumatoid fever which classically limits itself but may cause loss of function and adversely effect the quality of life. Although its diagnosis algorithm and differential diagnoses are clear, a consensus can not be reached due to conflicting data on treatment

Keywords: Chorea, Movement disorder, Sydenham’s chorea

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How to cite

1.
Yılmaz A, Yayıcı Köken Ö. Sydenham’s Chorea with a Pediatric Neurologist’s Point of View. Turk J Pediatr Dis [Internet]. 2021 May 25 [cited 2025 May 24];15(3):187-91. Available from: https://turkjpediatrdis.org/article/view/785