ST. VITUS' DANCE (Sydenham's Chorea; Rheumatic Chorea) |
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ST. VITUS' DANCE
(Sydenham's Chorea; Rheumatic Chorea)
DESCRIPTION
St. Vitus' dance is a temporary disorder of the parts of the brain that control movement and coordination. St. Vitus' dance is not contagious. The central nervous system--including the brain, the coverings of the brain (meninges), and the spinal cord -- and peripheral nerves are involved. St. Vitus' dance can affect children of both sexes but is more common in girls.
Appropriate health care includes:
Home care after diagnosis.
Physician's monitoring of general condition and medications.
Psychotherapy or counseling for the patient and family. Parents and teachers should understand that the unusual movements are temporary, and the condition is not contagious.
SIGNS & SYMPTOMS
Uncontrollable, purposeless and non-repetitive movements that are wandering or jerky. The eyes are not involved.
Facial grimacing that disappears during sleep.
Symptoms are similar to those of cerebral palsy, except these last for a limited time, while cerebral palsy lasts a lifetime.
CAUSES
A delayed (up to 6 months) complication of inadequately treated Group A streptococcal infections, usually of the throat or skin. St. Vitus' dance is more likely to occur in summer and early autumn.
RISK FACTORS
Prior strep infection.
PREVENTING COMPLICATIONS OR RECURRENCE
Obtain prompt antibiotic treatment for strep infections of the throat, tonsils, or skin. Your child should take medication at least 10 days.
A child who has had St. Vitus' dance should take daily antibiotics (usually penicillin or erythromycin) until adulthood to prevent strep infections.
OTHER
Use of phenothiazine drugs and other tranquilizers may produce symptoms identical to those of St. Vitus' dance, leading to misdiagnosis. If your child has these symptoms and takes these drugs, consult your doctor.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms. Sometimes the symptoms are so mild that you may think only that the child seems unusually clumsy.
Medical history and physical exam by a doctor.
Laboratory throat culture and tests of spinal fluid (to rule out other causes of symptoms).
EEG (See Glossary).
POSSIBLE COMPLICATIONS
Injury from involuntary movements.
Psychosocial problems.
PROBABLE OUTCOME
Spontaneous recovery in 3 to 6 months without lasting effects on personality, intelligence, emotions, or muscle control.
TREATMENT
HOME CARE
Keep your child away from dangerous implements, such as knives. Use plastic tableware with dull edges to prevent mouth injury.
Help the child dress and eat, if necessary.
Provide the child with love, support, and reassurance.
MEDICATION
Your doctor may prescribe:
Mild sedatives, tranquilizers, or muscle relaxants to control abnormal, unintentional movements and help prevent self-injury.
Cortisone drugs to control the child's movements if the above drugs fail.
Penicillin or other antibiotics until adulthood to prevent strep infections.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
Your child should resume normal activities as soon as possible. Try to educate teachers and classmates so the child can return to school -- even before all involuntary movements cease. Avoid bed rest.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?When appetite has returned and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of St. Vitus' dance.
Injury occurs from uncontrolled movements.
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