Clinical and Neuroimaging Findings of Sydenham’s Chorea

AUTHORS

Arzu Ekici 1 , * , Ayten Yakut 2 , Sevgi Yimenicioglu 3 , Kursat Bora Carman 4 , Suzan Saylısoy 5

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How to Cite: Ekici A, Yakut A, Yimenicioglu S, Bora Carman K , Saylısoy S. Clinical and Neuroimaging Findings of Sydenham’s Chorea, Iran J Pediatr. 2014 ; 24(3):300-306.

ARTICLE INFORMATION

Iranian Journal of Pediatrics: 24 (3); 300-306
Published Online: May 23, 2014
Article Type: Research Article
Received: October 14, 2013
Accepted: April 14, 2014

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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.

 

Keywords

Sydenham’s Chorea MRI Findings Chorea Paralytica Corticosteroids

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