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RHEUMATIC CHOREA

Rheumatic chorea, also known as Sydenham chorea, is an uncommon and rare neurological disorder that shows up with episodes of chorea. This is often noted during childhood. Chorea is described as random-appearing, progressing, involuntary movements that affects the whole body. It usually affects the face and the tongue. Symptoms may also be seen in the arms and legs.

There are other symptoms like slurring of speech and difficulty in maintaining a hand grip. Usually, Sydenham chorea affects children aged 5 years and above. A streptococcal infection may be an unusual major complication of acute rheumatic fever. It leads to an autoimmune abnormality and results when the body’s immune system falsely targets a part of the body, disrupting normal function.

SYMPTOMS

The severity of chorea and the existence of non-chorea symptoms of Sydenham chorea may range highly from one person to another. Most conditions follow a streptococcal infection. Streptococcus is a group of bacteria that causes certain infections. Most of them usually present with a sore throat or fever. The symptoms may appear anywhere from one week to six months following a streptococcal infection.

DIAGNOSIS

A diagnosis of Sydenham chorea is based on the new choreic actions, a detailed medical history, and thorough clinical evaluation. When there is new-onset chorea, which is unusual in childhood, a previous streptococcal infection and/or high blood titers of streptococcal antibodies is needed.

In some cases, an imaging technique such as magnetic resonance imaging (MRI) is suggested to rule out other causes. Because Sydenham chorea usually happens weeks after the infection, the particular signs of rheumatic fever or streptococcal infection are usually no longer present.

TREATMENT

Secondary Prevention
People with Sydenham chorea may need continuing antibiotic medication until adulthood. This is to avoid permanent heart valve damage which could result in problems such as frequent streptococcal infections.

Chorea-suppressing medications are also being studied. Some mild cases may not necessarily need medication because the disorder may resolve on its own.

Immune system treatment

People with Sydenham chorea during the first weeks of symptoms may have short-term immune therapies. This is based on the concept that acute inflammation is contributing to its symptoms. Using oral steroids and intravenous immunoglobulins may be beneficial according to some recent studies.

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