Sydenham's Chorea

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Recent Developments

Even with the research being done the incidence of Acute Rheumatic fever and rheumatic heart disease are not declining, in fact recent figures state Acute Rheumatic Fever as 0.6 - 0.7/1 000 population in the USA and Japan compared with 15 - 21/1 000 population in Asia and Africa. The prevalence of Acute Rheumatic Fever and Sydenham's Chorea has declined progressively in developed countries over the last decades. However can still be found anywhere around the world.

Bibliography

"Medical Dictionary." Sydenhams Chorea. Web. .

"MedLink." Web. 22 Jan. 2012. .

North, Alexander Frederick. Sydenham's Chorea, a Study of One Hundred and Three Cases. [..]. Print.

"Sydenham Chorea Information Page." National Institute of Neurological Disorders and Stroke (NINDS). Web. 22 Jan. 2012. .

"Sydenham Chorea." Rare Diseases - Information About Rare Diseases. Web. 22 Jan. 2012. .

"Sydenham's Chorea - an Infectious Disease of the Central Nervous System." Sydenham Town | The Community Website for London SE26. Web. 22 Jan. 2012. .

"Sydenham's Chorea | Doctor | Patient UK." Health Information and Advice | Medicines Guide | Patient.co.uk. Web. 22 Jan. 2012. .

"Sydenham's Chorea - Symptoms/Findings." MDVU - WE MOVE's Movement Disorder Virtual University. Web. 22 Jan. 2012. .

"Sydenham's Chorea." MDVU - WE MOVE's Movement Disorder Virtual University. Web. 22 Jan. 2012. .

"Thomas Sydenham - English Physician." Sydenham Town | The Community Website for London SE26. Web. 22 Jan. 2012. .

Lifestyle Changes

In the late 1500's early 1600's, before the time of Thomas Sydenham's, no evidence or research had been done on the disease. Most people believed the disorder to be a mental disorder. With no effective treatments accessible and little information about the symptoms, people with the disease were looked down apon. Families often sent diseased children away to live with distant relatives in order to avoid exposing their child to the harshness of society. However now a days with our advanced technology and research we can properly diagnose and cure people with Sydenham’s Chorea. Around 50 percent of patients recover within 2-6 months while in some cases the symptoms of Sydenham’s Chorea continue to exist even after 2 years. Patients must learn to cope with many of the symptoms, however they are only short term and can be cured.

Effect on body systems

Effect on the body systems:
Immune
Sydenham’s Chorea is caused by an immune infection called Acute Rheumatic Fever, this inflammatory disease causes an auto immune response reaction to the bacterium that is interfering with the normal function of the basal ganglia in the brain. The basal ganglia are in charge are fine motor movements and control. The Immune systems acts as the doorway into the body. Acute Rheumatic Fever develops subsequent to throat infection with certain strains of streptococcal bacteria. It affects multiple tissues and organs, including the joints, skin, and connective tissues directly beneath the skin (subcutaneous tissues), heart, and brain.

Nervous
Sydenham's Chorea is an infectious disease of the central nervous system. The disorder is an anti-neuronal antibody-mediated neuro-psychiatric disorder caused by a post streptococcal, autoimmune condition affecting control of movement, mood, behavior and potentially the heart. The random, writhing movements of chorea are caused by an interference with the basal ganglia that controls motor movements in the brain. Essentially what the disease does is it completely take over the nervous system by route of the immune system. After the virus has penetrated the body systems and the basal ganglia can no longer function normally, the messages to the brain and the neuro-receptors begin to "breakdown". In other words the person will experience loss control over the their movements, and even emotions.

Circulatory

Rheumatic fever is currently the major cause of acquired heart disease in children. Up to 60% of people are diagnosed with Sydenham’s Chorea will later develop rheumatic heart disease. Hence, when Sydenham’s Chorea is diagnosed, treatment strategies must include the prevention of rheumatic heart disease. Inflammation of the heart, or carditis, is another symptom of rheumatic fever. Symptoms include heart murmur, shortness of breath, rapid heartbeat, fluttering heartbeat and chest pain. If left untreated, rheumatic fever may result in permanent damage to the heart.

Treatment Principles

Treatment of Sydenham's Chorea is based on the following three principles:
1. The first phase of treatment is targeted at eliminating the streptococcus at the primary, secondary and tertiary levels. A ten day course of penecillin is prescribed when Sydenhams Chroea is first diagnosed, in order to treat throat and skin infections.

2. The second phase of treatment is targeted to eliminate the movement disorder (chorea). Haloperidol is frequently used due to its anti- dopaminergic effect. However this treatment has serious potential side effects. Though therapeutic efforts would be ideal the disease posses certain limitations to the therapeutic options.

3. Immunomodulatory, or in simply a drug that effects the immune system, interventions have also been implemented, in such forms as steroids, intravenous immunoglobulins, and plasma exchange.