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Sydenham Chorea


Sydenham chorea is a movement disorder occurring in conjunction with rheumatic fever, an inflammatory condition that may develop in children after an infection with Streptococcus A bacteria. Chorea describes a disorder of constant, abrupt, involuntary movements and this is a common symptom. Muscle weakness is present in all affected individuals with varying severity. Difficulties with eye movements, voice, and hand movements also occur. Swings in mood and other disturbances of feelings have been described. Children may develop features of obsessive compulsive disorder (OCD) or attention deficit hyperactivity disorder (ADHD), although the full disorder (known as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections or PANDAS), might not develop. In the cases where Sydenham chorea follows an infection, there may be a long delay between the infection and the start of symptoms. Blood tests and throat swabs may show evidence of the infection. A blood test for systemic lupus erythematosus (SLE; see entry Lupus) may be required for diagnosis as SLE can be mistaken for Sydenham chorea. Treatment is by high-dose antibiotic for ten days and most children recover well. There is a significant relapse rate and low-dose antibiotics may be recommended to continue until the age of 18 years to prevent further infection.

This overview is intended to be a basic description of the condition. It is not intended to replace specialist medical advice. We advise that you discuss your child's case with a qualified medical professional who will be able to give you more detailed information.


Medical text approved January 2013 by Dr Jenny Fisken (retired), formerly Associate Specialist in Community Paediatrics, North Yorkshire and York PCT.

Is there support?

There is no support group for Sydenham chorea in the UK. Cross referrals to other entries in The Contact a Family Directory are intended to provide relevant support for those particular features of the disorder. Organisations identified in those entries do not provide support specifically for Sydenham chorea.

Families can use Contact a Family's freephone helpline for advice, information and, where possible, links to other families. Contact a Family's web-based linking service can be accessed at