Sydenham's chorea
Classification and external resources
ICD-10	I02.
ICD-9	392
DiseasesDB	29245
MeSH	D002819

Sydenham's chorea or Chorea minor (also known as "Saint Vitus' Dance")^[1] is a disease characterized by rapid, uncoordinated jerking movements affecting primarily the face, feet and hands. SC results from childhood infection with Group A beta-hemolytic Streptococci ^[2]and is reported to occur in 20-30% of patients with rheumatic fever (RF). The disease is usually latent, occurring up to 6 months after the acute infection, but may occasionally be the presenting symptom of RF. SC is more common in females than males and most patients are children, below 18 years of age. Adult onset of SC is comparatively rare and most of the adult cases are associated with exacerbation of chorea following childhood SC.

SC is characterised by the acute onset (sometimes a few hours) of motor symptoms, classically chorea, usually affecting all limbs. Other motor symptoms include facial grimacing, hypotonia, loss of fine motor control and a gait disturbance. Fifty percent of patients with acute SC spontaneously recover after 2 to 6 months whilst mild or moderate chorea or other motor symptoms can persist for up to and over 2 years in some cases (for example a patient in the UK who has suffered the illness since 1999)^{[citation needed]}. Sydenham's is also associated with psychiatric symptoms with obsessive compulsive disorder being the most frequent manifestation. The PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections) syndrome is similar, but is not characterized by Sydenham's motor dysfunction, but presenting with tics and/or with psychological components (OCD) and much sooner, days to week after GABHS infection rather than 6-9 months.^[3] It is related to other illnesses such as Lupus and Tourette's.

Movements cease during sleep, and the disease usually resolves after several months. It is associated with post-streptococcal rheumatic fever, pregnancy, hyperthyroidism, and systemic lupus erythematosus.

It is named for British physician Thomas Sydenham, (1624-1689).^[4] The alternate eponym, Saint Vitus' dance, is in reference to Saint Vitus, a Christian saint who was persecuted by Roman emperors and died as a martyr in AD 303. Saint Vitus is considered to be the patron saint of dancers, with the eponym given as homage to the manic dancing that historically took place in front of his statue during the feast of Saint Vitus in Germanic and Latvian cultures.^[5]

St. Vitus' dance is noted as the malady suffered by the elderly physician from whom Dr. Watson purchased a medical practice in "The Stock-Broker's Clerk" by Arthur Conan Doyle, included in a number of Holmes' stories published collectively in The Memoirs of Sherlock Holmes.

American artist Andy Warhol was afflicted with rheumatic fever as a young child, and developed the symptoms of St. Vitus Dance.

[edit] References

[edit] External links

• synd/2226 at Who Named It?
• -596967410 at GPnotebook

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