Sydenham’s chorea: from pathophysiology to therapeutics

Antonio L. Teixeira, Luiz P. Vasconcelos, Maria do Carmo Pereira Nunes, Harvey Singer

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations

Abstract

Sydenham’s chorea is an autoimmune chorea emerging after a group A beta-hemolytic streptococcal (GABHS) infection, i.e. a rheumatic chorea with or without the presence of carditis or arthritis. The disorder, defined by the presence of chorea, is also associated with cognitive and behavioral symptoms, including emotional lability, anxiety, depressive and obsessive-compulsive symptoms. The authors review the pathophysiology, clinical characteristics, and available evidence on therapeutic strategies, the latter including the secondary prevention of GABHS infections, reduction of chorea, and immune modulation. Sydenham’s chorea has been regarded as a model for pediatric autoimmune neuropsychiatric disorders, however, the field is marked by conflicting results and controversies. Regarding therapeutics, there are limited high-quality interventional studies and the selection of treatment strategy often relies on the clinician’s experience. A serial treatment algorithm is presented based upon the severity of clinical presentation and response to symptomatic pharmacotherapy.

Original languageEnglish (US)
Pages (from-to)913-922
Number of pages10
JournalExpert Review of Neurotherapeutics
Volume21
Issue number8
DOIs
StatePublished - 2021
Externally publishedYes

Keywords

  • anti-basal ganglia antibodies
  • corticosteroids
  • dopamine antagonists
  • pandas
  • penicillin
  • rheumatic chorea
  • rheumatic fever
  • Sydenham’s chorea
  • treatment

ASJC Scopus subject areas

  • General Neuroscience
  • Clinical Neurology
  • Pharmacology (medical)

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