Sydenham’s chorea, commonly known as Saint Vitus Dance, is a neurological disorder primarily affecting children. This condition is characterized by involuntary, jerky movements predominantly affecting the face, arms, legs, and trunk. Beyond these motor symptoms, children with Saint Vitus dance may also experience reduced muscle tone, muscle weakness, and emotional and behavioral changes, notably obsessive-compulsive behaviors. The severity of symptoms can vary significantly, ranging from subtle facial tics, restlessness, and minor coordination issues to severe, debilitating involuntary movements that disrupt daily life. These choreic movements typically emerge gradually, worsening progressively over several weeks to a month.
Saint Vitus dance predominantly affects children between the ages of 5 and 15 years, with a higher prevalence in girls compared to boys. It is a sequela of acute rheumatic fever, a condition itself triggered by a streptococcal infection, typically appearing up to six months following the resolution of the fever. The underlying cause is believed to be an autoimmune response to the preceding streptococcal infection.
Due to the widespread use of antibiotics for treating streptococcal infections in children, Saint Vitus dance has become a relatively rare condition. It is estimated to occur in approximately 25% of children who have experienced rheumatic fever.
Managing Saint Vitus Dance
Currently, there is no specific cure for Saint Vitus dance. The condition is typically self-limiting, with symptoms naturally subsiding within approximately 3 to 6 months. Management strategies focus on supportive care and symptom control. Rest, creating a calm environment, and in some cases, sedative medications may be recommended to help manage the involuntary movements. Medications to directly control chorea may also be prescribed to alleviate more severe symptoms. Furthermore, prophylactic penicillin may be administered to prevent future streptococcal infections and subsequent episodes of rheumatic fever.
In some instances, subtle choreic movements and behavioral changes may persist even after the main symptoms have resolved. These residual effects can fluctuate in intensity over a period of a year or more.
Prognosis for Saint Vitus Dance
The long-term outlook for children with Saint Vitus dance is generally favorable. Most children achieve a full recovery, often within a few weeks of symptom onset.
However, it is important to note that recurrence of Saint Vitus dance is possible in approximately 20 percent of individuals, typically within the first two years following the initial episode. Recurrences have also been observed in women during pregnancy who had a history of rheumatic fever in childhood.
Further Resources and Support
For further information and support regarding Saint Vitus dance and related movement disorders, please refer to the following resources:
- Australian research papers on Sydenham’s Chorea
- International Parkinson and Movement Disorder Society: https://www.movementdisorders.org/MDS/About/Movement-Disorder-Overviews/Chorea–Huntingtons-Disease.htm
- National Institute of Neurological Disorders and Stroke: https://www.ninds.nih.gov/Disorders/All-Disorders/Sydenham-Chorea-Information-Page
Reviewed by Associate Professor James Colebatch
DISCLAIMER: This information is intended to support, not replace, the relationship between a patient and their healthcare professionals.
