Clinical and Neuroimaging Findings of Sydenham’s Chorea

Arzu Ekici; Ayten Yakut; Sevgi Yimenicioglu; Kursat  Bora Carman; Suzan Saylısoy

IJ Pediatrics

The Scientific Journal of Growth & Development Research Center

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Clinical and Neuroimaging Findings of Sydenham’s Chorea

Author(s):

Arzu Ekici^1,*,

Ayten Yakut²,

Sevgi Yimenicioglu³,

Kursat Bora Carman⁴,

Suzan Saylısoy⁵

IJ Pediatrics:Vol. 24, issue 3; 300-306

Published online:May 23, 2014

Article type:Research Article

Received:Oct 14, 2013

Accepted:Apr 14, 2014

How to Cite:Arzu EkiciAyten YakutSevgi YimeniciogluKursat Bora CarmanSuzan SaylısoyClinical and Neuroimaging Findings of Sydenham’s Chorea.Iran J Pediatr.24(3):300-306.

Abstract

Objective: Sydenham’s chorea (SC) is thought to be an autoimmune disorder. MRI is generally used to exclude other causes of chorea. There are no typically defined MRI features of SC. In this study we aimed to determine clinical and neuroimaging findings of SC.Methods: In this study 17 patients with acute SC were retrospectively evaluated. Sydenham’s chorea was diagnosed according to the 1992 revision of the Jones criteria. The other causes of chorea were excluded. Cranial MRI was performed in all patients during the acute phase of SC. Walking, speech and swallowing disorders, muscle weakness, behavioral disorders, treatment, symptom recovery time and recurrence were evaluated.Findings: The patients’ mean age was 11.2 years. Behavioral changes, muscle weakness and dysphagia occurred in 70%, 64% and 23% of the patients, respectively. Nonspecific signal hyperintensities were observed in the white matter, brain stem and caudate nucleus in 47% of patients. Two patients who had chorea paralytica were treated successfully with a high dose of intravenous methylprednisolone.Conclusion: Nonspecific hyperintense white matter abnormalities may be due to the inflammatory process associated with a longer duration of clinical signs. To explain the MRI findings and the pathogenesis of SC, comprehensive studies are needed.

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