Sydenham's chorea-clinical characteristics of nine patients

Abstract

Sydenham's chorea is still the most frequently seen form of acquired chorea in childhood in developing countries. Nine patients presented with Sydenham's chorea as one of the major criteria (one or more attacks) were evaluated their clinical characteristics and treatment. All patient were given sodium valproate. Clinical improvement began 11+/-4.0 days in sodium valproate treatment, and no adverse effect was seen due to the drugs. Echocardiography revealed rheumatic carditis sequela in all patient. The nine Sydenham's chorea patients presented 13 attacks of chorea in follow-up. We observed isolated chorea in 44% of patients, and 22% presented one or more recurrences. The interval between the attacks ranged from months to 2 years. The 90% of the patients were not on prophylaxis with benzathine penicillin. One patient had diagnosis of obsessive-compulsive disorder, and one had diagnosis of attention deficit hyperactivity disorder in the follow-up period. This report emphasizes the significance of Sydenham's chorea and sequela of rheumatic carditis association and a high risk of developing neuropsychiatric disorders in the follow-up period. Valproic acid is an effective and safe drug in the treatment of Sydenham's chorea.