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Sydenhams Chorea Sydenhams Chorea is a neurological disorder of the basal ganglia first identified in medical literature in 1686 by Thomas Sydenham This disorder has also been called acute chorea rheumatic chorea chorea minor infectious chorea and St Vitus dance The name St Vitus dance is derived from the Middle Ages when people who had this disease gathered in the chapels of St Vitus in belief that this Catholic patron saint of dancing had miraculous curative powers12 This type of chorea is a movement disorder as other types of chorea are Sydenhams chorea is characterized by involuntary irregular purposeless movements of the face including the tongue neck trunk and extremities The choreic movements usually begin gradually and progressively worsen over weeks to months The movements are absent when the person is asleep and resume when they wake up The true etiology of Sydenhams chorea is not known but it is considered to be triggered by a group A beta-hemolytic streptococci infection Sydenhams chorea is rare today due to the common use of antibiotics to treat strep infections3 The initial illness is usually a strep pharyngitis followed by a sudden onset of rheumatic fever within 1 to 5 weeks and possibly up to three months before the appearance of chorea The chorea occurs in about 25-33 of patients with rheumatic fever34 Sydenhams chorea usually resolves spontaneously in weeks to months occasionally years Relapses can occur after months to years in 20-33 of the cases56 The mechanism for the development of acute rheumatic fever ARF is also unclear Some evidence suggests that ARF may be an abnormal immune reaction and that Sydenhams chorea is an autoimmune response Sydenhams chorea most often occurs in children ages 3-15 and in pregnant women after acute rheumatic fever It is very rare anytime after adolescence except in pregnant women This disease affects female children about twice as frequently as males leading some researchers to believe there may be a
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