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Sydenham's chorea

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steroids from Israel, Italy and Brazil. Immunoglobulin has been used in Holland and South Africa. Some improvement can be seen within a few days of IV steroids. In Italy, prednisolone reduced average duration of symptoms from 9 weeks to 4 weeks, and these were severe cases. South African group found less neuropsychiatric complications at 6 months with IVIG treatment (IVIG preferred due to fear of TB reactivation).
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The incidence of acute rheumatic fever and rheumatic heart disease is not declining. Recent figures quote the incidence of Acute Rheumatic Fever as 0.6–0.7/1,000 population in the United States and Japan compared with 15–21/1,000 population in Asia and Africa. The prevalence of Acute Rheumatic Fever
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Recurrence is seen in 16–40% of cases. It is sometimes but not always associated with a rise in ASO titre or other evidence of new streptococcal infection. Recurrence is more likely with poor compliance with penicillin prophylaxis. It is more likely if there is failure to remit within 6 months of
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Recurrence is usually only chorea, even if the original case was associated with rheumatic fever. There are two total reports of heart disease worsening after recurrence of chorea. The Thailand study also had 2 cases where carditis, which had improved after initial diagnosis, came back again. Some
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Kumar, Raman Krishna; Antunes, Manuel J.; Beaton, Andrea; Mirabel, Mariana; Nkomo, Vuyisile T.; Okello, Emmy; Regmi, Prakash Raj; Reményi, Boglarka; Sliwa-Hähnle, Karen; Zühlke, Liesl Joanna; Sable, Craig; American Heart Association Council on Lifelong Congenital Heart Disease Heart Health in the
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is essential to treat cardiac features of rheumatic fever, even if subclinical (American Heart Association guideline). If there are not features to warrant a diagnosis of rheumatic fever, it is arguable whether cardiac risk justifies prophylaxis or not; however, it is likely to reduce recurrence.
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Immunosuppression is used inconsistently in Sydenham's chorea. The model of an autoimmune disorder would support its use. One randomized controlled trial of steroids from Paz, Brazil in 2006 (22 cases) showed remission reduced to 54 days from 119 days. Various other reports of use of oral or IV
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Gregorowski, Claire; Lochner, Christine; Martin, Lindi; Simmons, Candice; Kidd, Martin; Walker, Kathleen; Wilmshurst, Jo M.; Seedat, Soraya (1 February 2016). "Neuropsychological manifestations in children with Sydenham's chorea after adjunct intravenous immunoglobulin and standard treatment".
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Sydenham's chorea is more common in females than males, and most cases affect children between 5 and 15 years of age. Adult onset of Sydenham's chorea is comparatively rare, and the majority of the adult cases are recurrences following childhood Sydenham's chorea (although pregnancy and female
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Intramuscular penicillin given every 2–3 weeks is superior to a 4 weekly regime for preventing relapse, but a risk assessment may conclude that twice daily oral penicillin is sufficiently effective, less painful for the child, and less demanding on the family.
251:(pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) hypothesis has overlapping clinical features, but Sydenham's chorea is one of the exclusion criteria. PANDAS can present with chorea but more typically there are 521:
Eliminate the streptococcus – a course of penicillin is usually given at diagnosis to definitively clear any remaining streptococci (and avoid spread of a rheumatogenic clone), but there is no evidence that it makes any difference to the course of the
2217: 2202: 386:. Autoantibodies against basal ganglia proteins have been found in Sydenham's chorea but these are non-specific. Dopamine receptor autoantibodies have been reported to correlate with clinical symptoms. Whether these antibodies represent an 200:
It is a neuropsychiatric disorder, so besides the motor problems there is classically emotional lability (mood swings, or inappropriate mood), but also tics, anxiety, attention deficit etc. These can precede the motor symptoms.
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Chorea is distinctive, if the health care provider is familiar with it. The diagnosis is then made by the typical acute onset in the weeks following a sore throat or other minor infection, plus evidence of inflammation (raised
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and is one of the major criteria for it, although it sometimes occurs in isolation. The disease occurs typically a few weeks, but up to 6 months, after the acute infection, which may have been a simple sore throat
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Fusco, Carlo; Ucchino, Valentina; Frattini, Daniele; Pisani, Francesco; Della Giustina, Elvio (July 2012). "Acute and chronic corticosteroid treatment of ten patients with paralytic form of Sydenham's chorea".
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Gurkas, E; Karalok, ZS; Taskin, BD; Aydogmus, U; Guven, A; Degerliyurt, A; Bektas, O; Yilmaz, C (October 2016). "Predictors of recurrence in Sydenham's chorea: Clinical observation from a single center".
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Higher recurrence rates are seen with the longest follow up – relapse can be seen 10 years or more after the initial episode, so might be underestimated by series with shorter follow up.
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of dancers, with the eponym given as homage to the manic dancing that historically took place in front of his statue during the feast of Saint Vitus in Germanic and Latvian cultures.
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Maia, Débora P.; Fonseca, Patricia G.; Camargos, Sarah T.; Pfannes, Cláudia; Cunningham, Mauro C.; Cardoso, Francisco (June 2012). "Pregnancy in patients with Sydenham's Chorea".
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Wooding, Eva Louise; Morton, Michael John Stuart; Lim, Ming; Mitrofan, Oana; Mushet, Nadine; Sie, Adrian; Knight, Brodie; Ford, Tamsin; Newlove-Delgado, Tamsin (September 2023).
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Symptoms usually get worse over the course of two weeks, then stabilize, and finally begin to improve. Motor problems, including chorea, settle within an average of 2–3 months.
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The severity of the condition can vary from just some instability on walking and difficulty with handwriting, to the extreme of being wholly unable to walk, talk, or eat (
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Ekici, Filiz; Cetin, Ibrahim Ilker; Cevik, Berna-Saylan; Senkon, Oben Gözde; Alpan, Nursel; Değerliyurt, Aydan; Güven, Alev; Ateş, Can; Cakar, Nilgün (March 2012).
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10% reported long-term tremor in one study (10 years follow up). Long term neuropsychiatric difficulties are increasingly recognized (49 studies so far, especially
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can be difficult, and since these things are not uncommon they can potentially co-exist. Diagnosis is often delayed and attributed to another condition such as
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Faustino PC, Terreri MT, Rocha AJ, et al. (2003). "Clinical, laboratory, psychiatric and magnetic resonance findings in patients with sydenham chorea".
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Teixeira Jr., AntĂ´nio L.; Maia, DĂ©bora P.; Cardoso, Francisco (August 2005). "Treatment of acute Sydenham's chorea with methyl-prednisolone pulse-therapy".
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Paz, José A.; Silva, Clovis A.A.; Marques-Dias, Maria J. (April 2006). "Randomized Double-Blind Study With Prednisone in Sydenham's Chorea".
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Walker K, Lawrenson J, Wilmshurst JM (2006). "Sydenham's Chorea-clinical and therapeutic update 320 years down the line".
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Swedo SE, Leonard HL, Shapiro MB (1993). "Sydenham's Chorea:Physical and Psychological Symptoms of St Vitus Dance".
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Eshel E, Lahat E, Azizi E, et al. (1993). "Chorea as a manifestation of rheumatic fever-a 30-year survey".
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There are several historical case series reporting successful treatment of Sydenham's chorea by inducing fever.
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Further testing is directed more towards alternative diagnoses and other manifestations of rheumatic fever:
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Sutton, LP; Dodge, KG (1936). "Fever therapy in chorea and in rheumatic carditis with and without chorea".
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As with rheumatic fever, Sydenham's chorea is seen more often in less affluent communities, whether in the
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Young; Council on Cardiovascular Stroke Nursing; Council on Clinical Cardiology (17 November 2020).
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None of these tests are 100% reliable, particularly when the infection was some months previously.
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have been identified, the M protein and N-acetyl-beta-D-glucosamine, whereby infection leads to
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and the appearance of skipping or dancing. Underlying the abnormal movements is often low tone (
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Boersma, Nienke Anne; Schippers, Herman; Kuijpers, Taco; Heidema, Jojanneke (27 January 2016).
1325:"Childhood/adolescent Sydenham's chorea in the UK and Ireland: a BPSU/CAPSS surveillance study" 959:
Wilbur C, Bitnun A, Kronenberg S, Laxer RM, Levy DM, Logan WJ, Shouldice M, Yeh EA (May 2019).
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and Sydenham's Chorea has declined progressively in developed countries over the last decades.
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In the UK, there are approximately 20 cases per year, according to a BPSU surveillance study.
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Oosterveer, Daniëlla M.; Overweg-Plandsoen, Wilhelmina C.T.; Roos, Raymund A.C. (July 2010).
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Sydenham's chorea is characterized by the abrupt onset (sometimes within a few hours) of
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Nausieda PA, Grossman BJ, Koller WC, et al. (1980). "Sydenham's Chorea:An update".
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Fusco, C.; Spagnoli, C. (March 2018). "Corticosteroid treatment in Sydenham's chorea".
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Kyle, Kevin; Bordelon, Yvette; Venna, Nagagopal; Linnoila, Jenny (18 March 2022).
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Talley and O'Connor's Examination Medicine - epub: A Guide to Physician Training
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For the mysterious historical phenomenon also known as "St. Vitus' dance", see
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Heart involvement improves in about a third of cases (whether silent or not).
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Non-neurologic manifestations of acute rheumatic fever may be present, namely
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emperors and died as a martyr in AD 303. Saint Vitus is considered to be the
682:(1624–1689). The alternative eponym, "Saint Vitus Dance", is in reference to 4092: 3999: 3856: 3819: 3664: 3442: 3434: 2254: 2211: 2136: 1590: 576: 340: 209: 184: 58: 2154: 1973: 1943: 1919: 1896: 1871:"Neuropsychiatric manifestations of Sydenham's chorea: a systematic review" 1869:
Punukollu, M; Mushet, N; Linney, M; Hennessy, C; Morton, M (January 2016).
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Sutton, LP; Dodge, KG (1933). "The treatment of chorea by induced fever".
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Zomorrodi A, Wald ER (2006). "Sydenham's Chorea in Western Pennsylvania".
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is effective for controlling symptoms, but it does not speed up recovery.
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tongue, as the tongue slides in and out of the mouth), or eye closure.
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Management of Sydenham's chorea is based on the following principles:
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primarily affecting the face, hands and feet. Sydenham's chorea is an
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Differentiating these signs from other involuntary movements such as
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suggest that recurrent chorea is a different disease altogether.
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disease that results from childhood infection with Group A beta-
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Swedo SE, Leonard HL, Garvey M, et al. (February 1998).
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was used previously, but caused serious side effects e.g.
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Other disorders that may be accompanied by chorea include
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if the child is of school age. Speech is often affected (
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a cow), or inability to sustain tongue protrusion (called
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onset. Recurrence is associated in women with pregnancy (
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Martino D, Tanner A, Defazio G, et al. (May 2005).
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are a marker for widespread streptococcal transmission.
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biotin-thiamine-responsive basal ganglia disease (BTBGD)
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are useful for maintaining function and muscle tone.
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(2012). 531:Prevention of relapses and further cardiac damage 500:enlargement have been described in some patients) 398:Sydenham's chorea is primarily seen in children. 114:It is historically one of the conditions called 1808:The Journal of Laboratory and Clinical Medicine 1008:Sigra S, Hesselmark E, Bejerot S (March 2018). 48:Rheumatic chorea, chorea minor, St Vitus' dance 111:hormone treatment are also potential causes). 3417: 2322: 1955: 1953: 1264:Ben-Pazi H, Stoner JA, Cunningham MW (2013). 8: 1764:: CS1 maint: multiple names: authors list ( 859:Verma, Anoop; Kunju, P. A. M. (2019-05-31). 452:titre (peaks at 8–12 weeks after infection) 440:To confirm recent streptococcal infection: 4152: 4005: 3989: 3815: 3804: 3600: 3501: 3492: 3481: 3466: 3424: 3410: 3402: 2938: 2818: 2658: 2639:Arrhythmogenic right ventricular dysplasia 2509: 2351: 2329: 2315: 2307: 2185: 1875:Developmental Medicine and Child Neurology 1174:Cunningham, Madeleine W. (2 August 2019). 686:, a Christian saint who was persecuted by 140:). Typical chorea includes repeated wrist 63: 36: 2144: 1886: 1733: 1691: 1598: 1348: 1299: 1289: 1240: 1199: 1025: 984: 892:. Elsevier Health Sciences. p. 577. 798: 788: 390:or are pathogenic, remains to be proven. 1505:European Journal of Paediatric Neurology 1470:European Journal of Paediatric Neurology 648:attention-deficit hyperactivity disorder 3701:Cutaneous Streptococcus iniae infection 1672:Tremor and Other Hyperkinetic Movements 703: 351:One of the important manifestations of 2373:Spontaneous coronary artery dissection 1757: 259:with a psychological component (e.g., 83:rapid, uncoordinated jerking movements 374:being produced against host tissues ( 7: 3835:Staphylococcal scalded skin syndrome 2697:Nonbacterial thrombotic endocarditis 2179:Universidade Federal de Minas Gerais 1540:Parkinsonism & Related Disorders 1192:10.1128/microbiolspec.GPP3-0045-2018 828: 826: 824: 822: 820: 818: 738:Parkinsonism & Related Disorders 678:It is named after British physician 1443:10.1016/j.pediatrneurol.2005.08.028 931:10.1016/j.pediatrneurol.2009.11.015 862:IAP Textbook of Pediatric Neurology 297:familial dyskinesia–facial myokymia 171:, which is particularly obvious in 2993:Accelerated idioventricular rhythm 1063:The American Journal of Psychiatry 299:(Bird–Raskind syndrome) due to an 25: 4071:Clostridial necrotizing enteritis 1924:The Turkish Journal of Pediatrics 366:Two cross-reactive streptococcal 81:, is a disorder characterized by 2171:for patient & family support 2125:Archives of Disease in Childhood 1552:10.1016/j.parkreldis.2005.02.007 1341:10.1136/archdischild-2023-325399 1329:Archives of Disease in Childhood 750:10.1016/j.parkreldis.2011.12.013 563:. Case reports exist to support 361:group A β-hemolytic streptococci 359:response following infection by 3676:Group B streptococcal infection 3624:Group A streptococcal infection 2678:Subacute bacterial endocarditis 1027:10.1016/j.neubiorev.2018.01.001 2032:European Journal of Pediatrics 1840:10.1016/j.braindev.2016.04.010 197:Movements cease during sleep. 1: 3195:Pulseless electrical activity 3124:Multifocal atrial tachycardia 2998:Catecholaminergic polymorphic 2097:. Saints.sqpn.com. 2009-01-07 1962:South African Medical Journal 1793:10.1016/s0022-3476(33)80151-x 644:obsessive-compulsive disorder 492:of the brain (alterations in 490:computed tomography (CT) scan 4214:Erysipelothrix rhusiopathiae 2169:Sydenhams Chorea Association 1735:10.1161/CIR.0000000000000921 1291:10.1371/journal.pone.0073516 571:; other drugs tried include 525:Treat the movement disorder 277:bilateral striatal necrosis 167:There is usually a loss of 4263: 3139:Wandering atrial pacemaker 2686:non-infective endocarditis 2627:Endocardial fibroelastosis 1517:10.1016/j.ejpn.2017.11.011 1482:10.1016/j.ejpn.2011.12.005 835:Mosby's Medical Dictionary 486:Magnetic resonance imaging 458:titre (peaks at 3–5 weeks) 26: 3629:Streptococcal pharyngitis 3217:hexaxial reference system 3162:Jervell and Lange-Nielsen 2692:Libman–Sacks endocarditis 2177:, research from Brazil's 1781:The Journal of Pediatrics 1637:10.1007/s11011-015-9681-1 1400:10.1007/s00234-003-0999-8 790:10.3389/fneur.2022.829076 4109:Pseudomembranous colitis 4103:Clostridioides difficile 3097:Ventricular fibrillation 2368:Coronary artery aneurysm 534:Manage the disability - 273:benign hereditary chorea 4060:Clostridium perfringens 3771:Urinary tract infection 3374:Diastolic heart failure 3348:Athletic heart syndrome 3309:Ventricular hypertrophy 3043:Pre-excitation syndrome 2897:Left posterior fascicle 2422:Acute coronary syndrome 2362:Coronary artery disease 2137:10.1136/adc.2004.057679 1828:Brain & Development 1625:Metabolic Brain Disease 1591:10.1136/bcr-2015-211673 380:rheumatic heart disease 313:mitochondrial disorders 4247:Neurological disorders 4166:Ureaplasma urealyticum 3959:Listeria monocytogenes 3663:bacitracin resistant, 3522:Pneumococcal infection 2892:Left anterior fascicle 2672:infective endocarditis 2457:Hibernating myocardium 2338:Cardiovascular disease 1118:10.1542/peds.2005-1573 777:Frontiers in Neurology 601:Penicillin prophylaxis 514: 475:Electroencephalography 407:aboriginal communities 267:Differential diagnosis 228: 4187:Mycoplasma pneumoniae 4180:Mycoplasma genitalium 4019:Clostridium botulinum 3765:Enterococcus faecalis 3540:Viridans streptococci 3056:Wolff–Parkinson–White 3016:Premature contraction 2914:Adams–Stokes syndrome 2617:Loeffler endocarditis 2427:Myocardial infarction 2295:Sydenham's chorea 1180:Microbiology Spectrum 1075:10.1176/ajp.155.2.264 1014:Neurosci Biobehav Rev 965:Paediatr Child Health 512: 353:acute rheumatic fever 285:ataxia–telangiectasia 247:. The controversial 226: 148:("bag of worms") and 130:neurological symptoms 4193:Mycoplasma pneumonia 4172:Ureaplasma infection 3882:novobiocin resistant 3840:Toxic shock syndrome 3779:Enterococcus faecium 3223:Right axis deviation 3185:Sudden cardiac death 2543:Pericardial effusion 2486:Ventricular aneurysm 2001:10.1212/wnl.30.3.331 1242:10.1093/brain/aws256 536:Occupational therapy 317:Huntington's disease 309:Lesch–Nyhan syndrome 281:abetalipoproteinemia 4125:(non-spore forming) 3735:Streptococcus bovis 3695:Streptococcus iniae 3443:Infectious diseases 3228:Left axis deviation 3085:Atrial fibrillation 3080:Ventricular flutter 3003:Torsades de pointes 2877:Bundle branch block 2836:Sick sinus syndrome 2622:Cardiac amyloidosis 2607:Tachycardia-induced 2462:Myocardial stunning 2410:Prinzmetal's angina 2379:Coronary thrombosis 2074:"Sydenham's chorea" 1431:Pediatric Neurology 1282:2013PLoSO...873516B 919:Pediatric Neurology 652:affective disorders 547:Treatment of chorea 456:Anti-streptolysin O 329:lupus erythematosus 245:conversion disorder 227:Erythema marginatum 216:, and subcutaneous 214:erythema marginatum 150:motor impersistence 4033:Clostridium tetani 3916:Bacillus anthracis 3533:optochin resistant 3448:Bacterial diseases 3331:Atrial enlargement 3129:Pacemaker syndrome 3051:Lown–Ganong–Levine 2973:Junctional ectopic 2968:AV nodal reentrant 2474:Myocardial rupture 2384:Coronary vasospasm 2270:External resources 2044:10.1007/bf01955239 1888:10.1111/dmcn.12786 977:10.1093/pch/pxy145 596:Relapse prevention 561:tardive dyskinesia 515: 384:nephritic syndrome 229: 169:fine motor control 124:Signs and symptoms 4234: 4233: 4230: 4229: 4205:Anaeroplasmatales 4142: 4141: 4081: 4080: 3979: 3978: 3975: 3974: 3899: 3898: 3788: 3787: 3744: 3743: 3711: 3710: 3590: 3589: 3399: 3398: 3391:Obstructive shock 3295: 3294: 3242:Short QT syndrome 3209:Other / ungrouped 3200:Sinoatrial arrest 3115:Ectopic pacemaker 3011: 3010: 2831:Sinus bradycardia 2803: 2802: 2799: 2798: 2548:Cardiac tamponade 2501: 2500: 2491:Dressler syndrome 2389:Myocardial bridge 2304: 2303: 2175:UFMG rating scale 1728:(20): e337–e357. 1585:: bcr2015211673. 1235:(11): 3453–3468. 899:978-0-7295-8875-1 872:978-93-5270-979-3 845:978-0-323-83162-8 716:www.ninds.nih.gov 626:chorea gravidorum 587:Immunosuppression 528:Immunosuppression 413:. High rates of 376:molecular mimicry 337:drug intoxication 333:chorea gravidarum 305:glutaric aciduria 192:chorea paralytica 75:Sydenham's chorea 72: 71: 40:Sydenham's chorea 34:Medical condition 16:(Redirected from 4254: 4157:Mycoplasmataceae 4153: 4133:Finegoldia magna 4006: 3990: 3888:S. saprophyticus 3816: 3805: 3601: 3502: 3493: 3482: 3467: 3426: 3419: 3412: 3403: 3364:Cardiac fibrosis 3256:T wave alternans 3149:Long QT syndrome 2943:Supraventricular 2939: 2872:Intraventricular 2819: 2659: 2510: 2355:Coronary disease 2352: 2331: 2324: 2317: 2308: 2186: 2158: 2148: 2106: 2105: 2103: 2102: 2091: 2085: 2084: 2082: 2081: 2070: 2064: 2063: 2027: 2021: 2020: 1984: 1978: 1977: 1957: 1948: 1947: 1915: 1909: 1908: 1890: 1866: 1860: 1859: 1822: 1816: 1815: 1803: 1797: 1796: 1776: 1770: 1769: 1763: 1755: 1737: 1712: 1706: 1705: 1695: 1684:10.7916/d8w95gj2 1663: 1657: 1656: 1619: 1613: 1612: 1602: 1579:BMJ Case Reports 1570: 1564: 1563: 1535: 1529: 1528: 1500: 1494: 1493: 1464: 1455: 1454: 1426: 1420: 1419: 1383: 1377: 1376: 1369: 1363: 1362: 1352: 1320: 1314: 1313: 1303: 1293: 1261: 1255: 1254: 1244: 1220: 1214: 1213: 1203: 1171: 1165: 1164: 1144: 1138: 1137: 1101: 1095: 1094: 1054: 1048: 1047: 1029: 1005: 999: 998: 988: 956: 950: 949: 947: 945: 910: 904: 903: 883: 877: 876: 856: 850: 849: 830: 813: 812: 802: 792: 768: 762: 761: 733: 727: 726: 724: 722: 708: 608:Other treatments 553:sodium valproate 470:Echocardiography 403:developing world 79:rheumatic chorea 77:, also known as 68: 67: 37: 21: 18:Rheumatic chorea 4262: 4261: 4257: 4256: 4255: 4253: 4252: 4251: 4237: 4236: 4235: 4226: 4199: 4138: 4115: 4077: 4045: 3971: 3942: 3930:Bacillus cereus 3895: 3851: 3796: 3784: 3740: 3707: 3682: 3650: 3644:Rheumatic fever 3586: 3528: 3473: 3471:Lactobacillales 3456: 3430: 3400: 3395: 3386:Rheumatic fever 3352: 3291: 3204: 3171: 3143: 3101: 3060: 3037: 3007: 2979: 2926: 2918: 2812: 2795: 2703: 2652: 2643: 2559: 2553:Hemopericardium 2497: 2438: 2432:Unstable angina 2405:Angina pectoris 2398:Active ischemia 2393: 2341: 2335: 2305: 2300: 2299: 2265: 2264: 2197: 2165: 2118: 2115: 2113:Further reading 2110: 2109: 2100: 2098: 2093: 2092: 2088: 2079: 2077: 2072: 2071: 2067: 2029: 2028: 2024: 1986: 1985: 1981: 1959: 1958: 1951: 1917: 1916: 1912: 1868: 1867: 1863: 1824: 1823: 1819: 1805: 1804: 1800: 1778: 1777: 1773: 1756: 1714: 1713: 1709: 1665: 1664: 1660: 1621: 1620: 1616: 1572: 1571: 1567: 1537: 1536: 1532: 1502: 1501: 1497: 1466: 1465: 1458: 1428: 1427: 1423: 1385: 1384: 1380: 1371: 1370: 1366: 1322: 1321: 1317: 1263: 1262: 1258: 1222: 1221: 1217: 1173: 1172: 1168: 1146: 1145: 1141: 1103: 1102: 1098: 1056: 1055: 1051: 1007: 1006: 1002: 958: 957: 953: 943: 941: 912: 911: 907: 900: 885: 884: 880: 873: 858: 857: 853: 846: 832: 831: 816: 770: 769: 765: 735: 734: 730: 720: 718: 710: 709: 705: 700: 680:Thomas Sydenham 676: 667: 618: 610: 598: 589: 551:Treatment with 549: 507: 494:caudate nucleus 481:Lumbar puncture 426: 396: 349: 325:hyperthyroidism 303:gene mutation, 269: 158:jack-in-the-box 126: 117:St Vitus' dance 100:rheumatic fever 62: 35: 32: 23: 22: 15: 12: 11: 5: 4260: 4258: 4250: 4249: 4239: 4238: 4232: 4231: 4228: 4227: 4225: 4224: 4223: 4222: 4209: 4207: 4201: 4200: 4198: 4197: 4196: 4195: 4183: 4176: 4175: 4174: 4161: 4159: 4150: 4144: 4143: 4140: 4139: 4137: 4136: 4128: 4126: 4117: 4116: 4114: 4113: 4112: 4111: 4098: 4096: 4088:Clostridioides 4083: 4082: 4079: 4078: 4076: 4075: 4074: 4073: 4068: 4055: 4053: 4047: 4046: 4044: 4043: 4042: 4041: 4029: 4028: 4027: 4014: 4012: 4003: 3987: 3981: 3980: 3977: 3976: 3973: 3972: 3970: 3969: 3968: 3967: 3954: 3952: 3944: 3943: 3941: 3940: 3939: 3938: 3936:Food poisoning 3926: 3925: 3924: 3911: 3909: 3901: 3900: 3897: 3896: 3894: 3893: 3892: 3891: 3879: 3878: 3877: 3874:S. epidermidis 3861: 3859: 3853: 3852: 3850: 3849: 3848: 3847: 3842: 3837: 3824: 3822: 3813: 3810:Staphylococcus 3802: 3790: 3789: 3786: 3785: 3783: 3782: 3775: 3774: 3773: 3756: 3754: 3746: 3745: 3742: 3741: 3739: 3738: 3727: 3721: 3719: 3713: 3712: 3709: 3708: 3706: 3705: 3704: 3703: 3690: 3688: 3684: 3683: 3681: 3680: 3679: 3678: 3660: 3658: 3652: 3651: 3649: 3648: 3647: 3646: 3641: 3636: 3631: 3626: 3609: 3607: 3598: 3592: 3591: 3588: 3587: 3585: 3584: 3576: 3569: 3562: 3555: 3548: 3536: 3534: 3530: 3529: 3527: 3526: 3525: 3524: 3511: 3509: 3499: 3490: 3479: 3464: 3458: 3457: 3455: 3454: 3445: 3431: 3429: 3428: 3421: 3414: 3406: 3397: 3396: 3394: 3393: 3388: 3383: 3382: 3381: 3379:Cardiac asthma 3376: 3366: 3360: 3358: 3354: 3353: 3351: 3350: 3345: 3344: 3343: 3338: 3328: 3327: 3326: 3321: 3316: 3305: 3303: 3297: 3296: 3293: 3292: 3290: 3289: 3287:Strain pattern 3284: 3283: 3282: 3277: 3272: 3260: 3259: 3258: 3246: 3245: 3244: 3232: 3231: 3230: 3225: 3212: 3210: 3206: 3205: 3203: 3202: 3197: 3192: 3187: 3181: 3179: 3177:Cardiac arrest 3173: 3172: 3170: 3169: 3164: 3159: 3157:Andersen–Tawil 3153: 3151: 3145: 3144: 3142: 3141: 3136: 3131: 3126: 3121: 3111: 3109: 3103: 3102: 3100: 3099: 3094: 3093: 3092: 3082: 3077: 3075:Atrial flutter 3071: 3069: 3062: 3061: 3059: 3058: 3053: 3047: 3045: 3039: 3038: 3036: 3035: 3030: 3025: 3019: 3017: 3013: 3012: 3009: 3008: 3006: 3005: 3000: 2995: 2989: 2987: 2981: 2980: 2978: 2977: 2976: 2975: 2970: 2960: 2959: 2958: 2947: 2945: 2936: 2920: 2919: 2917: 2916: 2911: 2910: 2909: 2904: 2899: 2894: 2889: 2884: 2874: 2869: 2868: 2867: 2862: 2857: 2847: 2838: 2833: 2827: 2825: 2816: 2805: 2804: 2801: 2800: 2797: 2796: 2794: 2793: 2792: 2791: 2786: 2774: 2773: 2772: 2767: 2755: 2754: 2753: 2748: 2736: 2735: 2734: 2729: 2724: 2711: 2709: 2705: 2704: 2702: 2701: 2700: 2699: 2694: 2682: 2681: 2680: 2667: 2665: 2656: 2645: 2644: 2642: 2641: 2636: 2635: 2634: 2629: 2624: 2619: 2614: 2609: 2604: 2599: 2598: 2597: 2585:Cardiomyopathy 2582: 2581: 2580: 2578:Chagas disease 2569: 2567: 2561: 2560: 2558: 2557: 2556: 2555: 2550: 2540: 2539: 2538: 2529: 2518: 2516: 2507: 2503: 2502: 2499: 2498: 2496: 2495: 2494: 2493: 2488: 2478: 2477: 2476: 2466: 2465: 2464: 2459: 2448: 2446: 2440: 2439: 2437: 2436: 2435: 2434: 2429: 2419: 2418: 2417: 2412: 2401: 2399: 2395: 2394: 2392: 2391: 2386: 2381: 2376: 2370: 2365: 2358: 2356: 2349: 2343: 2342: 2336: 2334: 2333: 2326: 2319: 2311: 2302: 2301: 2298: 2297: 2286: 2274: 2273: 2271: 2267: 2266: 2263: 2262: 2251: 2240: 2229: 2214: 2198: 2193: 2192: 2190: 2189:Classification 2183: 2182: 2172: 2164: 2163:External links 2161: 2160: 2159: 2114: 2111: 2108: 2107: 2086: 2065: 2038:(8): 645–646. 2022: 1995:(3): 331–334. 1979: 1968:(9): 906–912. 1949: 1930:(2): 159–167. 1910: 1861: 1817: 1798: 1771: 1707: 1658: 1631:(1): 205–212. 1614: 1565: 1546:(5): 327–330. 1530: 1511:(2): 327–331. 1495: 1476:(4): 373–378. 1456: 1437:(4): 264–269. 1421: 1394:(7): 456–462. 1388:Neuroradiology 1378: 1364: 1335:(9): 736–741. 1315: 1256: 1215: 1166: 1155:(4): 706–713. 1139: 1112:(4): 675–679. 1096: 1049: 1000: 951: 905: 898: 878: 871: 851: 844: 814: 763: 744:(5): 458–461. 728: 702: 701: 699: 696: 675: 672: 666: 663: 617: 614: 609: 606: 597: 594: 588: 585: 581:phenobarbitone 548: 545: 544: 543: 532: 529: 526: 523: 506: 503: 502: 501: 483: 478: 472: 460: 459: 453: 447: 445:Throat culture 425: 422: 395: 392: 372:autoantibodies 348: 345: 321:Wilson disease 268: 265: 146:fasciculations 142:hyperextension 132:, classically 125: 122: 70: 69: 56: 50: 49: 46: 42: 41: 33: 24: 14: 13: 10: 9: 6: 4: 3: 2: 4259: 4248: 4245: 4244: 4242: 4221: 4218: 4217: 4216: 4215: 4211: 4210: 4208: 4206: 4202: 4194: 4191: 4190: 4189: 4188: 4184: 4182: 4181: 4177: 4173: 4170: 4169: 4168: 4167: 4163: 4162: 4160: 4158: 4154: 4151: 4149: 4145: 4135: 4134: 4130: 4129: 4127: 4124: 4123: 4118: 4110: 4107: 4106: 4105: 4104: 4100: 4099: 4097: 4094: 4090: 4089: 4084: 4072: 4069: 4067: 4064: 4063: 4062: 4061: 4057: 4056: 4054: 4052: 4048: 4040: 4037: 4036: 4035: 4034: 4030: 4026: 4023: 4022: 4021: 4020: 4016: 4015: 4013: 4011: 4007: 4004: 4001: 3997: 3996: 3991: 3988: 3986: 3982: 3966: 3963: 3962: 3961: 3960: 3956: 3955: 3953: 3951: 3950: 3945: 3937: 3934: 3933: 3932: 3931: 3927: 3923: 3920: 3919: 3918: 3917: 3913: 3912: 3910: 3908: 3907: 3902: 3890: 3889: 3885: 3884: 3883: 3880: 3876: 3875: 3871: 3870: 3869: 3867: 3863: 3862: 3860: 3858: 3854: 3846: 3843: 3841: 3838: 3836: 3833: 3832: 3831: 3830: 3826: 3825: 3823: 3821: 3817: 3814: 3812: 3811: 3806: 3803: 3800: 3795: 3791: 3781: 3780: 3776: 3772: 3769: 3768: 3767: 3766: 3761: 3758: 3757: 3755: 3753: 3752: 3747: 3737: 3736: 3731: 3728: 3726: 3723: 3722: 3720: 3718: 3714: 3702: 3699: 3698: 3697: 3696: 3692: 3691: 3689: 3685: 3677: 3674: 3673: 3672: 3671: 3670:S. agalactiae 3666: 3662: 3661: 3659: 3657: 3653: 3645: 3642: 3640: 3637: 3635: 3634:Scarlet fever 3632: 3630: 3627: 3625: 3622: 3621: 3620: 3619: 3615:susceptible: 3614: 3611: 3610: 3608: 3606: 3602: 3599: 3597: 3593: 3583: 3581: 3577: 3575: 3574: 3570: 3568: 3567: 3563: 3561: 3560: 3556: 3554: 3553: 3549: 3547: 3546: 3541: 3538: 3537: 3535: 3531: 3523: 3520: 3519: 3518: 3517: 3516:S. pneumoniae 3513: 3512: 3510: 3507: 3503: 3500: 3498: 3494: 3491: 3489: 3488: 3487:Streptococcus 3483: 3480: 3477: 3472: 3468: 3465: 3463: 3459: 3453: 3449: 3446: 3444: 3440: 3436: 3433: 3432: 3427: 3422: 3420: 3415: 3413: 3408: 3407: 3404: 3392: 3389: 3387: 3384: 3380: 3377: 3375: 3372: 3371: 3370: 3369:Heart failure 3367: 3365: 3362: 3361: 3359: 3355: 3349: 3346: 3342: 3339: 3337: 3334: 3333: 3332: 3329: 3325: 3322: 3320: 3317: 3315: 3312: 3311: 3310: 3307: 3306: 3304: 3302: 3298: 3288: 3285: 3281: 3280:ST depression 3278: 3276: 3273: 3271: 3268: 3267: 3266: 3265: 3261: 3257: 3254: 3253: 3252: 3251: 3247: 3243: 3240: 3239: 3238: 3237: 3233: 3229: 3226: 3224: 3221: 3220: 3219: 3218: 3214: 3213: 3211: 3207: 3201: 3198: 3196: 3193: 3191: 3188: 3186: 3183: 3182: 3180: 3178: 3174: 3168: 3165: 3163: 3160: 3158: 3155: 3154: 3152: 3150: 3146: 3140: 3137: 3135: 3132: 3130: 3127: 3125: 3122: 3120: 3116: 3113: 3112: 3110: 3108: 3104: 3098: 3095: 3091: 3088: 3087: 3086: 3083: 3081: 3078: 3076: 3073: 3072: 3070: 3068: 3063: 3057: 3054: 3052: 3049: 3048: 3046: 3044: 3040: 3034: 3031: 3029: 3026: 3024: 3021: 3020: 3018: 3014: 3004: 3001: 2999: 2996: 2994: 2991: 2990: 2988: 2986: 2982: 2974: 2971: 2969: 2966: 2965: 2964: 2961: 2957: 2954: 2953: 2952: 2949: 2948: 2946: 2944: 2940: 2937: 2934: 2930: 2925: 2921: 2915: 2912: 2908: 2907:Trifascicular 2905: 2903: 2900: 2898: 2895: 2893: 2890: 2888: 2885: 2883: 2880: 2879: 2878: 2875: 2873: 2870: 2866: 2863: 2861: 2858: 2856: 2853: 2852: 2851: 2848: 2846: 2842: 2839: 2837: 2834: 2832: 2829: 2828: 2826: 2824: 2820: 2817: 2815: 2810: 2806: 2790: 2789:regurgitation 2787: 2785: 2782: 2781: 2780: 2779: 2775: 2771: 2770:regurgitation 2768: 2766: 2763: 2762: 2761: 2760: 2756: 2752: 2751:regurgitation 2749: 2747: 2744: 2743: 2742: 2741: 2737: 2733: 2732:regurgitation 2730: 2728: 2725: 2723: 2720: 2719: 2718: 2717: 2713: 2712: 2710: 2706: 2698: 2695: 2693: 2690: 2689: 2688: 2687: 2683: 2679: 2676: 2675: 2674: 2673: 2669: 2668: 2666: 2664: 2660: 2657: 2655: 2650: 2646: 2640: 2637: 2633: 2630: 2628: 2625: 2623: 2620: 2618: 2615: 2613: 2610: 2608: 2605: 2603: 2600: 2596: 2593: 2592: 2591: 2588: 2587: 2586: 2583: 2579: 2576: 2575: 2574: 2571: 2570: 2568: 2566: 2562: 2554: 2551: 2549: 2546: 2545: 2544: 2541: 2537: 2533: 2530: 2528: 2525: 2524: 2523: 2520: 2519: 2517: 2515: 2511: 2508: 2504: 2492: 2489: 2487: 2484: 2483: 2482: 2479: 2475: 2472: 2471: 2470: 2467: 2463: 2460: 2458: 2455: 2454: 2453: 2450: 2449: 2447: 2445: 2441: 2433: 2430: 2428: 2425: 2424: 2423: 2420: 2416: 2415:Stable angina 2413: 2411: 2408: 2407: 2406: 2403: 2402: 2400: 2396: 2390: 2387: 2385: 2382: 2380: 2377: 2374: 2371: 2369: 2366: 2363: 2360: 2359: 2357: 2353: 2350: 2348: 2344: 2339: 2332: 2327: 2325: 2320: 2318: 2313: 2312: 2309: 2296: 2292: 2291: 2287: 2285: 2281: 2280: 2276: 2275: 2272: 2268: 2261: 2257: 2256: 2252: 2250: 2246: 2245: 2241: 2239: 2235: 2234: 2230: 2228: 2224: 2223: 2219: 2215: 2213: 2209: 2208: 2204: 2200: 2199: 2196: 2191: 2187: 2180: 2176: 2173: 2170: 2167: 2166: 2162: 2156: 2152: 2147: 2142: 2138: 2134: 2131:(5): 507–11. 2130: 2126: 2122: 2117: 2116: 2112: 2096: 2090: 2087: 2075: 2069: 2066: 2061: 2057: 2053: 2049: 2045: 2041: 2037: 2033: 2026: 2023: 2018: 2014: 2010: 2006: 2002: 1998: 1994: 1990: 1983: 1980: 1975: 1971: 1967: 1963: 1956: 1954: 1950: 1945: 1941: 1937: 1933: 1929: 1925: 1921: 1914: 1911: 1906: 1902: 1898: 1894: 1889: 1884: 1880: 1876: 1872: 1865: 1862: 1857: 1853: 1849: 1845: 1841: 1837: 1834:(9): 827–34. 1833: 1829: 1821: 1818: 1813: 1809: 1802: 1799: 1794: 1790: 1787:(6): 813–26. 1786: 1782: 1775: 1772: 1767: 1761: 1753: 1749: 1745: 1741: 1736: 1731: 1727: 1723: 1719: 1711: 1708: 1703: 1699: 1694: 1689: 1685: 1681: 1677: 1673: 1669: 1662: 1659: 1654: 1650: 1646: 1642: 1638: 1634: 1630: 1626: 1618: 1615: 1610: 1606: 1601: 1596: 1592: 1588: 1584: 1580: 1576: 1569: 1566: 1561: 1557: 1553: 1549: 1545: 1541: 1534: 1531: 1526: 1522: 1518: 1514: 1510: 1506: 1499: 1496: 1491: 1487: 1483: 1479: 1475: 1471: 1463: 1461: 1457: 1452: 1448: 1444: 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Index

Rheumatic chorea
Dancing mania
Specialty
Neurology
Edit this on Wikidata
rapid, uncoordinated jerking movements
autoimmune
haemolytic
Streptococcus
rheumatic fever
pharyngitis
St Vitus' dance
neurological symptoms
chorea
hyperextension
fasciculations
hand milking
jack-in-the-box
serpentine
fine motor control
handwriting
dysarthria
gait
hypotonia
carditis
arthritis
erythema marginatum
nodules
Classic rash of rheumatic fever
tics

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