The link between mental illness and viral/bacterial/parasitic infections is proving to be greater than we ever imagined. Many neurological disorders are now known to be caused by infections in addition to already known genetic and other factors. Sydenham’s chorea (SD) is a neurological disorder that is produced by the bacterium that causes rheumatic fever. It is an acute symptom of rheumatic fever and in some cases the only sign that a patient is ill. SD mostly occurs in children ages 5 to 15. However, it can arise in pregnant women. It is a gender selective disorder that presents in prepubescent females more often than males.
SD is characterized by uncoordinated movements, muscular weakness, stumbling, falling, slurring of speech, difficulties with writing, trouble concentrating and emotional instability which can include loss of emotional control, periods of inappropriate laughing or crying and obsessive compulsive disorder. There is usually a history of the patient having a sore throat for several weeks before the onset of SD. Onset is usually rapid, however, it can be insidious meaning that symptoms can gradually develop. In these cases of slow onset, the symptoms can be present for up to five weeks before they become troublesome enough to seek medical attention. However, in some children, symptoms might not arise for 6 month after the infection and/or fever has been treated and cleared.
Blood testing is currently used to identify specific proteins associated with the disorder. They can also be used to detect markers that indicate an erythrocyte sedimentation rate (ERS) of rheumatic fever which is another good indication of SD. ERS is a test that indirectly checks the level of inflammation in one’s body.
Treatment is fairly basic. Those who only have a mild case will be prescribed several days of bed rest. Those with more severe cases will need a medical professional to prescribe antibiotics to kill the bacterium that caused rheumatic fever. SD symptoms usually lessen and clear in several months. However, for those with severe cases, future antibiotics are usually prescribed as well. There is currently a debate as to if those who had SD should be treated with antibiotics until age 18 or for the duration of their life to prevent the return of symptoms. Additionally, in some cases, psychopharmacological drugs are prescribed with the antibiotics to help control the severity of involuntary movements, emotional outbursts and OCD behaviors. These too, however, usually clear in several months for most cases.
References
Frey, R., Polsdorfer, J., “Sydenham’s chorea.” A Dictionary of Nursing. 2008, & “Sydenham’s chorea.” The Columbia Encyclopedia, 6th ed.. 2015. (2005). Sydenham’s Chorea. Retrieved December 3, 2015, from http://www.encyclopedia.com/topic/Sydenhams_Chorea.aspx
NINDS Sydenham Chorea Information Page. (n.d.). Retrieved December 3, 2015, from http://www.ninds.nih.gov/disorders/sydenham/sydenham.htm
Washington, H. (2015, November 3). Catching Madness. Retrieved November 29, 2015, from https://www.psychologytoday.com/articles/201511/catching-madness?collection=1081138
Crystal K. Bray
WKPIC Doctoral Intern