Objective: To describe clinical profile and treatment outcome of Sydenham’s chorea (SC) in children attending a tertiary care hospital in Dakar, Senegal.

Background: SC is a rare complication of acute rheumatic fever (ARF). It can occur after an untreated group A β-hemolytic streptococcus infection (1). SC is the commonest cause of acquired chorea in childhood. Although it is few reported in developed countries because of the treatment improvement, literature still found cases in developing countries (2).

Methods: A retrospective  study was conducted at the Neurology Department of Fann National Teaching Hospital. All records of children under 15 years old,diagnosed with SC between July 2003 and July 2009 were reviewed. Age at onset, clinical features, investigations, treatment given and outcome data were collected.

Results: Overall 10 children records were reviewed. The mean age at onset of SC was 8.7 years (range 7-10) with a female predominance (60%). No history of throat infection was found and 1 child had family history of ARF. Onset symptoms was subacute in all. Chorea was generalized in 9 children (90%) and 1 child had hemichorea. Other neurological disorders included axial hypotonia (100%) and no psychiatric signs were present. Laboratory findings were elevated serum level of: antistreptolysin O in 5 children; erythrocyte sedimentation rate and /or C-reactive protein in 8 children. Echocardiogram showed mitral regurgitation (50%). Brain imaging was not done. Chorea treatment in the 10 children included haloperidol (0.075 mg/kg/day for an average of 5 months). Etiological treatment included penicillin for ten days and antibiotic prophylaxis. Cessation of chorea 3 months after the treatment initiation was observed in 90 % of cases.

Conclusions: SC is still present in this senegalese population children. Promptly managed, the outcome was favorable in our study but 

primary prevention remains the best treatment.
 

References: 1.      Guidelines for the diagnosis of rheumatic fever. Jones Criteria, 1992 update. Special Writing Group of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young of the American Heart Association. JAMA. 1992;268:2069–73.

2.      Walker KG, Wilmshurst JM. An update on the treatment of Sydenham’s chorea: the evidence for established and evolving interventions. Therapeutic Advances in Neurological Disorders. 2010;3(5):301-309.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/syndenhams-chorea-in-senegalese-children-a-case-series/