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Sydenham Chorea: What’s in a Name?

This childhood movement disorder is an inflammatory response to strep throat or rheumatic fever and is characterized by rapid, involuntary, irregular movements of all muscles except those that move the eyes. The condition was named for St. Vitus, the patron saint of dancers, who was born in Sicily in 209 AD and died 13 years later. Since 836 A.D., the saint has been commemorated in Germany where celebrants dance jubilantly. It is likely that the irregular movements of the children with this condition resembled those dancers.

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 A Sydenham’s Chorea Story

Sydenhams Chorea is the prototype disorder for PANDAS. If you or your child has chorea movements, it is important to get a correct diagnosis. One may have an easier time getting IVIG with an SC diagnosis rather than a PANDAS diagnosis.

Articles of Interest

Can't stop dancing Could it be St. Vitus' dance?

It is vital that each case of streptococcal pharyngitis be treated with appropriate antibiotic therapy. Doing so will help prevent the sequelae associated with streptococcal infections, such as acute rheumatic fever (ARF) and Sydenham's chorea.

Chorea: A Journey through History

Defined as a syndrome more than a century ago, it is now acknowledged that chorea has various etiologies (genetic, structural, infectious, autoimmune, toxic metabolic, and drug induced) and a wide and complex differential diagnosis.

Modern illness or a thing of the past?

You would not be alone if you had never heard of Sydenham’s chorea (abbreviated to SC). The condition used to be known as ‘St Vitus’ Dance’ in the past, because the main feature of chorea involves irregular, involuntary and purposeless movements which have been described as ‘dance-like’. In fact, the word chorea comes from the Ancient Greek term for dancing. SC is a rare condition associated with prior group A streptococcal infection and largely affecting children and young people. It can occur in isolation or as part of rheumatic fever. Neurological symptoms, including chorea and muscle weakness, can range from mild to severe, and can affect activities at home and school, including eating, dressing, speaking, writing and walking (Walker KM et al. 2010). At the peak of their illness children may become entirely dependent on their families.

Overcoming Sydenham’s Chorea and PANDAS—Three Sisters’ Healing and Autoimmune Challenges

We first learned about the bizarre things strep can do to children when our oldest child lost control of her body at the age of 11. It started with a couple of tics: flicking her hands, rolling her tongue, shrugging. We thought they might be some sort of pre-adolescent mannerisms. But over the next two weeks, she started moving constantly, twisting and flapping in a crazy-looking dance. She couldn’t drink from a cup without splashing the contents in her face. When I read to her at bedtime, her arm flew out and hit me in the mouth.

Saint Vitus' dance: vital misconceptions by Sydenham and Bruegel

. It may surprise doctors and medical students who are familiar with the name Vitus and St Vitus Dance, to discoverthat several centuries ago Vitus experienced an identity crisis: from protector of victims of dancing mania to those suffering from a disease now known as Sydenham's chorea.

St. Vitus Dance

Finally, fed up with her behavior, Ted had enough. Wanting the night to end and the madness to stop, with a great heave he pushed her into the middle of the street. Maribel hit the concrete with a thud, but her arms and legs kept jerking, propelling her upwards. She turned hear head just in time to see a taxi coming in her direction at top speed. As she tried to gain enough control over her legs to get out of the street to safety, Ted’s body came flying at her at full force, knocking her onto the sidewalk as the cab hit his body, the impact sending it hurdling down the street.

Therapeutic aspects of Sydenham’s Chorea: an update

Sydenham’s Chorea (SC) is a hyperkinetic movement disorder associated with neuropsychiatric manifestations. It is believed to be caused by the autoimmune response following a group A beta-hemolytic streptococcal (GABHS) pharyngitis, and it is one of the major diagnostic criteria for Acute Rheumatic Fever (ARF) diagnosis. Despite having been known and studied for centuries, there are still no standardized therapies or official guidelines for SC treatment, so that it is necessarily left to physicians’ clinical experience.

Who exactly was St Vitus and was he any good at dancing?

In 17th Century Germany it was reputed that dancing in front of a statue of Vitus on his feast day (15 June) would guarantee good health for the following year. Such dancing to excess is said to have been confused with the Sydenham's chorea - hence the illness's popular name of St. Vitus's Dance.

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StatPearls

Sydenham chorea, or St. Vitus dance, is caused by group A β-hemolytic streptococcal infections and is a manifestation of rheumatic fever that occurs in up to 40 percent of patients with rheumatic fever. Anti-basal ganglia antibodies develop and attack portions of the brain, leading to pathologic findings and symptoms. Sydenham chorea is much less common today than it was in the past. When it does occur, however, the symptoms are typically less severe, and the relapses are less frequent.