St Vitus Dance, medically known as Sydenham’s chorea, is a neurological disorder primarily affecting children. This condition is characterized by involuntary, jerky movements that typically impact the face, arms, legs, and trunk. Beyond these noticeable physical manifestations, St Vitus Dance can also present with reduced muscle tone, muscle weakness, and emotional or behavioral changes, notably obsessive-compulsive tendencies.
The severity of St Vitus Dance symptoms can vary significantly. In milder cases, children might exhibit facial grimacing, restlessness, and slight coordination issues. However, in more severe instances, the involuntary movements can become so pronounced that they significantly impair a child’s ability to perform everyday activities and function normally. The onset of these choreic movements is usually gradual, intensifying progressively over a period spanning from a few weeks to a month.
St Vitus Dance predominantly affects children between the ages of 5 and 15 years. It is observed more frequently in girls than in boys. This condition is recognized as a delayed complication following an episode of acute rheumatic fever, which itself is triggered by a streptococcal infection. St Vitus Dance can emerge up to six months after the rheumatic fever has subsided. The underlying cause is believed to be an autoimmune response triggered by the preceding streptococcal infection.
Thanks to the widespread use of antibiotics in treating childhood infections, St Vitus Dance has become a less common disorder today. It is estimated to occur in approximately 25% of children who have experienced rheumatic fever.
Treatment Strategies for St Vitus Dance
Currently, there is no cure specifically designed for St Vitus Dance. The condition is typically self-limiting, with symptoms naturally resolving within about 3 to 6 months. Management strategies focus on alleviating symptoms and providing supportive care.
Doctors may recommend bed rest to minimize physical exertion and stress. Sedatives can be prescribed to help manage restlessness and irritability. Medications aimed at controlling the involuntary movements, such as chorea, may also be part of the treatment plan. Furthermore, penicillin prophylaxis might be administered to prevent future streptococcal infections, thereby reducing the risk of recurrent rheumatic fever and potential exacerbation of St Vitus Dance.
In some instances, subtle signs of chorea and behavioral irregularities may persist even after the main symptoms have subsided. These residual effects can fluctuate in intensity over a period of a year or even longer.
Prognosis and Long-Term Outlook
The prognosis for children diagnosed with St Vitus Dance is generally favorable. The vast majority of children achieve a full recovery, often within a few weeks from the time symptoms first appear.
However, it’s important to note that recurrence is possible in approximately 20 percent of patients. These recurrences typically happen within the first two years following the initial episode. Interestingly, there have been reports of St Vitus Dance recurring during pregnancy in women who had a history of acute rheumatic fever in their childhood.
Further Resources and Support
For those seeking more in-depth information and support regarding St Vitus Dance and related conditions, the following resources are available:
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International Parkinson and Movement Disorder Society: https://www.movementdisorders.org/MDS/About/Movement-Disorder-Overviews/Chorea–Huntingtons-Disease.htm
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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: The information provided here is intended to support, not replace, the relationship between a patient and their healthcare professionals.
