Sydenham chorea, also known as rheumatic chorea or St. Vitus' dance, is a rare movement disorder that develops as a complication of acute rheumatic fever. Although this disorder is currently rare, understanding its causes, symptoms and treatment options is crucial to ensure effective management of the disease and improve the quality of life of affected patients.
Causes of Sydenham's Chorea
Sydenham's Chorea originates as a consequence of a previous infection by group A streptococci, the same microorganism responsible for scarlet fever and streptococcal pharyngitis. When the immune system overreacts to this bacterial infection, it triggers an autoimmune response that attacks the body's own cells, including brain cells. This autoimmune process inflames the striatum, a region of the brain responsible for regulating movement, resulting in the characteristic symptoms of Sydenham's chorea.
Risk factors
While Group A streptococcal infection is the main trigger of Sydenham chorea, not everyone who has had a streptococcal infection will develop this disorder. Some risk factors that may increase the likelihood of getting Sydenham's Chorea include:
- Age: Sydenham's Chorea mainly affects children between 5 and 15 years old, although it can also occur in adults.
- History of rheumatic fever: Those who have previously had rheumatic fever are at increased risk of developing Sydenham's Chorea.
- Genetics: There is evidence that susceptibility to Sydenham's Chorea may be influenced by genetic factors.
Sydenham Chorea Symptoms
Sydenham Chorea symptoms usually appear a few weeks after the initial streptococcal infection and can vary in its intensity and duration. The most common symptoms include:
Involuntary movements
The main characteristic of Sydenham Chorea is involuntary, sudden and erratic movements, which mainly affect the muscles of the face. , the limbs and the trunk. These movements can be unpredictable and make everyday tasks such as writing, eating, or dressing difficult.
Changes in muscle tone
In addition to involuntary movements, patients with Sydenham's Chorea may experience changes in muscle tone, which translates into increased or decreased muscle rigidity. These changes can affect the individual's coordination and balance.
Behavioral and emotional problems
Some patients with Sydenham's chorea may present with alterations in behavior and mood, such as irritability, anxiety, personality changes or difficulties in concentration and memory.
Neurological complications
In severe cases, Sydenham's Chorea may be associated with neurological complications such as neurological disorders. speech, seizures, or cognitive problems. These complications can significantly interfere with the patient's quality of life if they are not treated appropriately.
Diagnosis of Sydenham's Chorea
The diagnosis of Sydenham's Chorea is based on the evaluation clinical symptoms of the patient, medical history and complementary tests to rule out other possible causes of involuntary movements. Some tests that may be helpful in diagnosing Sydenham chorea include:
Blood tests
Blood tests can detect the presence of antibodies to group A streptococci, suggesting a previous infection that could have triggered Sydenham Chorea. These tests can also rule out other possible causes of symptoms, such as metabolic disorders or viral infections.
Brain MRI
Brain MRI can help identify possible changes in the brain. that may be associated with Sydenham Korea. Through detailed images of the brain, doctors can visualize swollen or damaged areas that support the diagnosis of this disorder.
Electroencephalogram (EEG)
An EEG can be useful in evaluating the electrical activity of the brain and rule out other neurological disorders that may be causing the patient's symptoms. This test can help differentiate Sydenham's Chorea from other movement disorders.
Treatment of Sydenham's Chorea
Treatment of Sydenham's Chorea focuses on relieving symptoms, control involuntary movements and prevent future complications. Below are some common therapeutic options for managing Sydenham Chorea:
Medications
Drugs that block dopamine, such as haloperidol and risperidone, may be prescribed. to control involuntary movements and improve the patient's quality of life. Other drugs, such as anticonvulsants, can also be used in specific cases.
Physical and occupational therapy
Physical and occupational therapy can be of great help to improve coordination, strength muscle and flexibility in patients with Sydenham's chorea. These therapies focus on developing motor skills and promoting independence in daily activities.
Psychological support
The emotional impact of Sydenham Chorea should not be underestimated, so support Psychological and emotional is essential in the comprehensive management of the disease. Working with a psychologist or psychiatrist can help the patient face the emotional and psychological challenges associated with the disease.
Regular medical follow-up
Regular medical follow-up is essential to monitor progress of Sydenham Korea, adjust treatment as necessary and prevent the development of long-term complications. Patients with Sydenham's Chorea should be cared for by a medical team specialized in movement disorders.
Conclusions
In conclusion, Sydenham's Chorea is a rare movement disorder that It develops as a consequence of a previous infection with group A streptococcus. Its characteristic symptoms, which include involuntary movements, changes in muscle tone and emotional problems, can have a significant impact on patients' quality of life. Early diagnosis and appropriate treatment are essential to ensure effective management of the disease and improve long-term prognosis.