Rare DiseasesUnderstand Sydenham Chorea and Its Management

Understand Sydenham Chorea and Its Management

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Sydenham chorea, commonly known as St. Vitus dance, is a neurological disorder that emerges as a symptom of rheumatic fever. This condition particularly develops in connection with rheumatic fever during childhood. It occurs due to an autoimmune reaction that can appear in some individuals exposed to a streptococcal bacterial infection.

Symptoms of Sydenham chorea include sudden and involuntary muscle movements, especially tremors or twitches in the face, hands, and feet, balance issues, speech disorders, and rhythmic movements. These symptoms typically accompany rheumatic fever indicators such as fever and sore throat.

Sydenham chorea typically appears several weeks or months after the infection heals. Treatment aims to manage symptoms and reduce inflammation. Nonsteroidal anti-inflammatory drugs and corticosteroids can be used to alleviate symptoms. Additionally, antibiotics against streptococcal bacteria may sometimes be prescribed to treat an infection that could cause reactive rheumatic chorea. In most cases of Sydenham chorea, symptoms improve over time, but in some instances, symptoms may persist.

What Are the Causes of Sydenham Chorea?

Sydenham chorea emerges as a symptom of rheumatic fever and usually develops as an autoimmune reaction linked to a streptococcal bacterial infection. This condition can appear as a result of rheumatic fever in some individuals. Streptococcal bacteria can cause upper respiratory tract infections, such as throat infections. In some people exposed to this bacterium, an autoimmune reaction that attacks their own tissues can develop.

Although the exact cause of Sydenham chorea is not known, it is thought to involve an autoimmune mechanism. As a result of this autoimmune reaction, inflammation and changes affecting the nervous system functions may occur in certain areas of the brain. Therefore, Sydenham chorea is considered a complication of rheumatic fever.

What Are the Symptoms of Sydenham Chorea?

Sydenham chorea usually appears as a symptom of rheumatic fever and can lead to various neurological symptoms. These symptoms may include:

  • sudden and involuntary muscle movements
  • tremors or twitches
  • balance issues
  • speech disorders

How Is Sydenham Chorea Diagnosed?

Doctors usually diagnose Sydenham chorea through clinical symptoms and the patient’s medical history. A doctor will evaluate the symptoms and gather information about past infections and the onset of symptoms. Additionally, during a physical examination, the doctor will assess the patient’s muscle movements and neurological findings.

To support the diagnosis, blood tests may be conducted. These tests can be used to check levels of specific antibodies, such as antistreptolysin O antibodies, which are indicators of rheumatic fever. Furthermore, imaging tests like electroencephalography or magnetic resonance imaging can be performed to show changes in brain activity.

The clinical symptoms and laboratory test results are considered for diagnosing Sydenham chorea, as there is no definitive diagnostic test for this condition. However, neurological examinations and tests may be conducted during the diagnostic process to rule out other neurological conditions.

How Is Sydenham Chorea Treated?

Treatment for Sydenham chorea aims to manage symptoms and is closely related to the treatment of rheumatic fever. Treatment is typically carried out as follows:

Antibiotics: Sydenham chorea usually appears as a symptom of rheumatic fever, so it is important to treat the streptococcal infection causing rheumatic fever.

Anti-inflammatory drugs: Nonsteroidal anti-inflammatory drugs can be used to alleviate symptoms and reduce inflammation.

Corticosteroids: Corticosteroids can help control inflammation and immune system reactions.

Symptomatic treatment: Treatment methods targeting symptoms can also be utilized. For example, muscle relaxants may be prescribed for tremors or muscle spasms.

How Should Sydenham Chorea Be Managed?

Managing Sydenham chorea involves alleviating symptoms, providing comfort to the patient, and controlling the infection caused by rheumatic fever. Management may include:

Regular Follow-up: During these follow-ups, symptoms are evaluated, the treatment plan is reviewed, and adjustments are made as needed.

Antibiotic Therapy: Antibiotics are used to control the streptococcal infection.

Symptomatic Treatment: Anti-inflammatory drugs can be used to reduce pain and inflammation, or muscle relaxants can be used to control muscle spasms.

Physical Therapy and Rehabilitation: If necessary, rehabilitation methods such as physical therapy or speech therapy can be used.

Education and Support: Patients and their families should be informed about the course of the disease, treatment options, and precautions.

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