Document Detail


Sydenham's Chorea.
MedLine Citation:
PMID:  18579027     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Sydenham's chorea (SC) is a manifestation of acute rheumatic fever (ARF). Although the incidence of SC has declined significantly, particularly in developed areas, it remains the most common cause of acute chorea in children worldwide. Recent data show that SC accounts for almost all cases of chorea in children in the United States. As there is no specific laboratory marker of this condition, the diagnosis relies on a careful clinical history and laboratory assessment to rule out alternative causes. Morbidity is primarily related to cardiac lesions in ARF. It is recommended that all patients with suspected SC submit to a cardiologic evaluation. Neurologic features encompass motor signs, among which chorea is the most prominent, and nonmotor symptoms such as obsessive-compulsive behavior and attention-deficit/hyperactivity disorder. The first-line treatment of SC is valproic acid. Patients who do not respond to this drug or who present with severe chorea (particularly chorea paralytica, in which the muscle tone is so decreased that patients are bedridden) should be treated with risperidone. Other dopamine receptor-blocking drugs, such as haloperidol, may also be useful. There is growing evidence that immunosuppressive treatment, such as intravenous methylprednisolone followed by a tapering course of oral prednisone, is effective. This option has been used in patients who failed to respond to (or did not tolerate) the previously mentioned therapies. Plasmapheresis and intravenous immunoglobulin are regarded as experimental treatments. Obsessive-compulsive behavior associated with SC is not usually as severe as in other conditions such as Tourette's syndrome. Finally, because at least 20% of patients with SC experience recurrent attacks of ARF, they carry a high risk of developing severe cardiac lesions. These patients require prophylaxis against streptococcus infection, using penicillin or sulfa drugs.
Authors:
Francisco Cardoso
Related Documents :
10616987 - Current evaluation of cardiac stab wounds.
16527827 - Selecting patients for cardiac resynchronization therapy: electrical or mechanical dyss...
15950577 - Brachial artery flow-mediated dilation and myocardial perfusion in patients with cardia...
19454537 - Haemodialysis patients longitudinally assessed by highly sensitive cardiac troponin t a...
12115357 - Higher oxidation and lower antioxidant levels in peripheral blood plasma and bone marro...
17136377 - Diaphragmatic rupture: a frequently missed injury in blunt thoracoabdominal trauma pati...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current treatment options in neurology     Volume:  10     ISSN:  1092-8480     ISO Abbreviation:  Curr Treat Options Neurol     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-06-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815940     Medline TA:  Curr Treat Options Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  230-5     Citation Subset:  -    
Affiliation:
Francisco Cardoso, MD, PhD Movement Disorders Unit - Neurology Service, Internal Medicine Department, Federal University of Minas Gerais Medical School, Av Pasteur 89/1107, 30150-290 Belo Horizonte MG, Brazil. cardosofe@terra.com.br.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Myoclonus.
Next Document:  Clinical performance of antigen-specific interferon-gamma assay for the diagnosis of latent tubercul...