Picture religious pilgrims of the Middle Ages on their way to the shrine of St. Vitus for healing. Their arms and legs twitch and jerk as if dancing in an inspired frenzy. "St. Vitus Dance" was the common name for what was later termed Sydenham chorea, after a British physician who recognized that the "dance" was a central nervous system disorder.
Autoimmune reaction
Sydenham chorea comes not from religious fervor but from an autoimmune reaction after a streptococcal infection. Occurring in children between the ages of 5 and 15 (peak incidence at 8 years old), the symptoms of Sydenham chorea may appear suddenly or gradually, and may occur at the beginning of the infection or weeks after it is over.
Symptoms and diagnosis
Diagnosis of the disorder is mostly based on the symptoms the patient shows, since it is often hard to tell if the patient had a streptococcal infection (especially if it was mild or occurred many weeks before). Symptoms of Sydenham chorea may include:
- an increased nervousness or restlessness
- involuntarily making faces (grimacing)
- some incoordination, such as trouble writing
- trouble with speaking and memory
- purposeless movements of the arms and legs, and muscle weakness.
Treatment
Penicillin may be prescribed if the child is in the midst of a streptococcal infection or rheumatic fever. It may also be prescribed as a preventive measure (prophylactic) to avoid future streptococcal infections. Treatment of the chorea focuses on relieving the symptoms, so bed rest may be ordered, and medicines such as sedatives or diazepam (Valium) may be helpful for severe cases.
Will eventually go away
Sydenham chorea, in most cases, eventually goes away with no lasting effects left behind. The symptoms may persist for anywhere from 3 weeks to 3 months before they are completely gone. Relapses happen sometimes, and sometimes a child will be troubled by symptoms off and on for a year. Because streptococcal infection may cause rheumatic fever, the child with Sydenham chorea may develop heart problems (carditis) or arthritis from the untreated infection.
Information for this article was taken from:
- Sydenham Chorea, online information from the National Institute for Neurological Disorders and Stroke.
- Thomas, C. L. (Ed.) (1993). Sydenham chorea, in Taber's Cyclopedic Medical Dictionary, 17th ed., p. 1922. Philadelphia: F.A. Davis Company.
