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Sydenham Chorea

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161. Levetiracetam in the Treatment of Neuroleptic-induced Tardive Dyskinesia

Subjects must have a stable neuroleptic-induced tardive dyskinesia at least 1 month prior to screening and meet tardive dyskinesia severity criteria Subjects must have used antipsychotics for at least 6 cumulative months, and, be on a stable dose for 1 month prior to screening Exclusion Criteria: Presence of any axis II condition within 6 months prior to screening Huntington´s disease, idiopathic dystonia, Wilson´s disease, Sydenham´s chorea, thyroid dysfunction, spontaneous dyskinesia Start of drugs

2005 Clinical Trials

162. Neuropsychiatric movement disorders following streptococcal infection. (PubMed)

Neuropsychiatric movement disorders following streptococcal infection. The aim of this study was to describe post-streptococcal movement disorders that form part of the acute rheumatic fever complex. The clinical records of patients diagnosed with Sydenham's chorea were analyzed retrospectively to investigate epidemiology, the significance of socioeconomic deprivation, clinical manifestations, treatments, outcomes, long-term morbidity, and disease evolution. Forty-two patients (21 males, 21 (...) females) were diagnosed with Sydenham's chorea. The median presentation age was 9 years 8 months (range 3y 5mo to 13y 2mo). Nineteen patients were of indigenous African ancestry; 23 were of mixed ancestry. All patients lived in poverty and had poor access to medical care. Twelve of the total group had disabling symptoms for longer than 2 years; six of these patients developed paediatric autoimmune neuropsychiatric disorder associated with Streptococcus (Paediatric autoimmune neuropsychiatric disorder

2005 Developmental Medicine and Child Neurology

163. Parkinsonian features after streptococcal pharyngitis. (PubMed)

Parkinsonian features after streptococcal pharyngitis. Bradykinesia and rigidity developed in a 10-year-old girl during an episode of Sydenham chorea. These parkinsonian features improved over 6 months. Serum analysis demonstrated elevated anti-streptolysin-O and anti-basal ganglia antibodies. We suggest that autoimmune antibodies may cause remitting parkinsonian signs subsequent to streptococcal tonsillitis as part of the spectrum of poststreptococcal CNS disease.

2003 Journal of Pediatrics

164. Echocardiographic findings in the PANDAS subgroup. (PubMed)

Echocardiographic findings in the PANDAS subgroup. Sydenham's chorea is the neurologic manifestation of rheumatic fever and is a diagnosis of exclusion requiring only the presence of frank chorea in the absence of another neurologic disorder. Two thirds of children with Sydenham's chorea also have rheumatic carditis (pathologic mitral valve regurgitation). Although there are similar neuropsychiatric symptoms and preceding group A beta-hemolytic streptococcal infection associated with both (...) Sydenham's chorea and the PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) subgroup, it is unknown whether patients in the PANDAS subgroup have any cardiac involvement.Sixty children meeting the criteria for PANDAS were entered into protocols at National Institute of Mental Health between 1993 and 2002. Doppler and 2-dimensional echocardiograms were performed on these subjects to assess valvular heart disease.Of these 60 children, no echocardiographic

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2004 Pediatrics

165. A dystonic syndrome associated with anti-basal ganglia antibodies. (PubMed)

in Sydenham's chorea. Three patients had a clear history of respiratory infection before the onset of their symptoms. Three patients received immunosuppressive treatment, with three showing a notable reduction in symptoms. It is hypothesised that dystonia in adults or adolescents may be part of the clinical spectrum of the post-infectious syndrome associated with ABGA. (...) A dystonic syndrome associated with anti-basal ganglia antibodies. Anti-basal ganglia antibodies (ABGA) have been associated with movement disorders (usually tics and chorea) and psychiatric disturbance in children. This report describes five adult and adolescent patients (one male, four females; mean age of onset, 16 years (range, 13-35)) who presented subacutely with a clinical syndrome dominated by dystonia and had ABGA binding to antigens of similar molecular weights to those seen

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2004 Neurosurgery and Psychiatry

166. Dementia-like presentation of striatal hypermetabolic state with antistriatal antibodies responsive to steroids. (PubMed)

Dementia-like presentation of striatal hypermetabolic state with antistriatal antibodies responsive to steroids. Hypermetabolic lesions of the striatum are rare. They usually involve autoimmunity and are associated with choreatic disorders such as Sydenham chorea, lupus, and the antiphospholipid antibody syndrome.A 48-year-old woman was initially seen with a 1-year history of progressive changes in personality and attention. There were minor associated involuntary movements. Negative routine

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2004 Archives of Neurology

167. Encephalitis lethargica syndrome: 20 new cases and evidence of basal ganglia autoimmunity. (PubMed)

% respectively). Investigation found no evidence of viral encephalitis or other recognized causes of rapid-onset parkinsonism. MRI of the brain was normal in 60% but showed inflammatory changes localized to the deep grey matter in 40% of patients. We investigated the possibility that this phenotype could be a postinfectious autoimmune CNS disorder, and therefore similar to Sydenham's chorea. Anti-streptolysin-O titres were elevated in 65% of patients. Furthermore, western immunoblotting showed that 95% of EL

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2004 Brain

168. Tourette's syndrome: a cross sectional study to examine the PANDAS hypothesis. (PubMed)

Tourette's syndrome: a cross sectional study to examine the PANDAS hypothesis. The classical neurological disorder after group A beta haemolytic streptococcal infection is Sydenham's chorea. Recently a tic disorder occurring after group A streptococcal infection has been described and termed PANDAS (paediatric autoimmune neuropsychiatric disorders associated with streptococcal infection). It is proposed that antibodies induced after group A streptococcal infection react with basal ganglia (...) neurones in Sydenham's chorea and PANDAS. Anti-basal ganglia antibodies (ABGA) are present in most cases of acute Sydenham's chorea, but rarely in controls.To investigate the hypothesis that Tourette's syndrome may be associated with group A streptococcal infection and ABGA.100 patients with Tourette's syndrome (DSM-IV-TR) were enrolled in a cross sectional study. Children with neurological disease (n = 50) and recent uncomplicated streptococcal infection (n = 40), adults with neurological disease (n

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2003 Neurosurgery and Psychiatry

169. Incidence of anti-brain antibodies in children with obsessive-compulsive disorder. (PubMed)

Incidence of anti-brain antibodies in children with obsessive-compulsive disorder. Obsessions and compulsions may occur in the post-streptococcal disorders Sydenham's chorea and paediatric autoimmune neuropsychiatric disorders associated with streptococcus (PANDAS). The proposed mediators are anti-basal ganglia antibodies (ABGA).We tested the hypothesis that post-streptococcal autoimmunity may have a role in'idiopathic'obsessive-compulsive disorder (OCD).We examined 50 children with OCD (...) for ABGA using enzyme-linked immunosorbent assay (ELISA) and western immunoblotting. The findings were compared with paediatric autoimmune (n=50), neurological (n=100) and streptococcal (n=40) controls.The mean ABGA binding on ABGA binding on ELISA was elevated in the patient cohort compared with all control groups (P<0.005 in all comparisons). Western immunoblotting revealed positive antibody binding (as seen in Sydenham's chorea) in 42% of the patient cohort compared with 2-10% of control groups (P

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2005 British Journal of Psychiatry

170. Dyskinesias and associated psychiatric disorders following streptococcal infections. (PubMed)

Dyskinesias and associated psychiatric disorders following streptococcal infections. The classical extrapyramidal movement disorder following beta haemolytic streptococcus (BHS) infection is Sydenham's chorea (SC). Recently, other post-streptococcal movement disorders have been described, including motor tics and dystonia. Associated emotional and behavioural alteration is characteristic.To describe experience of post-streptococcal dyskinesias and associated co-morbid psychiatric features (...) disorders were present: chorea (n = 20), motor tics (n = 16), dystonia (n = 5), tremor (n = 3), stereotypies (n = 2), opsoclonus (n = 2), and myoclonus (n = 1). Sixty five per cent of the chorea patients were female, whereas 69% of the tic patients were male. ICD-10 psychiatric diagnoses were made in 62.5%. Using the same psychiatric instrument, only 8.9% of UK children would be expected to have an ICD-10 psychiatric diagnosis. Emotional disorders occurred in 47.5%, including obsessive-compulsive

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2004 Archives of Disease in Childhood

171. Tourette's syndrome: clinical features, pathophysiology, and therapeutic approaches. (PubMed)

of poststreptococcal disease, such as in Sydenham's chorea. Cases of childhood TS are proposed to be caused by such a poststreptococcal mechanism, being part of a spectrum of childhood neurobehavioral disorders termed pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANDAS). The overlap between TS and PANDAS is discussed, and a critical view of the PANDAS concept is presented. The therapeutic implications of the different pathological mechanisms are described, taking

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2007 Dialogues in Clinical Neuroscience

172. Annotation: PANDAS: a model for human autoimmune disease. (PubMed)

by observations of similar symptoms in children with Sydenham's chorea, a search was undertaken for clinical and laboratory evidence in support of the new syndrome.Consistent and predictable clinical findings have been described in a large case series. Magnetic resonance imaging has supported the postulated pathobiology of the syndrome with evidence of inflammatory changes in basal ganglia. Antibasal ganglia antibodies have been found in some acute cases, mimicking streptococcal antigen epitopes.While PANDAS

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2005 Journal of Child Psychology and Psychiatry

173. Brain Imaging of Childhood Onset Psychiatric Disorders, Endocrine Disorders and Healthy Children

, childhood-onset schizophrenia, dyslexia, obsessive compulsive disorder, Sydenham's chorea, and Tourette's syndrome. Results of the MRIs showing the anatomy of the brain and brain function will be compared across age, sex (gender), and diagnostic groups. Correlations between brain and behavioral measures will be examined for normal and clinical populations. Condition or disease XXY (Klinefelter) Sex Chromosome Variation Sex Chromosome Aneuploidy XXXY XXXXXY XYY (Jacob) XXYY X (XO, Turner) XXX (Trisomy X

1999 Clinical Trials

174. A pilot study of penicillin prophylaxis for neuropsychiatric exacerbations triggered by streptococcal infections. (PubMed)

A pilot study of penicillin prophylaxis for neuropsychiatric exacerbations triggered by streptococcal infections. Some children with obsessive-compulsive disorder (OCD) and tic disorders appear to have symptom exacerbations triggered by group A beta-hemolytic streptococcal infections in a manner that is similar to rheumatic fever and its neurologic variant, Sydenham's chorea. Because penicillin prophylaxis has proven to be effective in preventing recurrences of rheumatic fever

1999 Biological psychiatry

175. Preventive Measures for Childhood-Onset Obsessive-Compulsive Disorder and Tic Disorders (PANDAS Subgroup)

infections. In this subgroup, periodic exacerbations appear to be triggered by GABHS infections in a manner similar to that of Sydenham's chorea, the neurological variant of rheumatic fever. Rheumatic fever is a disorder with a presumed post-streptococcal autoimmune etiology. The streptococcal pathogenesis of rheumatic fever is supported by studies that have demonstrated the effectiveness of penicillin prophylaxis in preventing recurrences of this illness. A trial of penicillin prophylaxis in the PANDAS (...) History of rheumatic fever, including Sydenham's chorea Diagnosis of autism, schizophrenia or other psychotic disorder Chronic illnesses, particularly neurologic and immunologic disorders Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00001359

1999 Clinical Trials

176. Is obsessive–compulsive disorder an autoimmune disease? (PubMed)

streptococcal infections and the development of OCD and tic disorders in children. It has been suggested that OCD in some susceptible individuals may be caused by an autoimmune response to streptococcal infections, that is, a similar biological mechanism to that associated with Sydenham's chorea. The term "pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections" (PANDAS) has been used to describe a subset of children with abrupt onset or exacerbations of OCD or tics, or both

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2001 CMAJ: Canadian Medical Association Journal

177. Sydenham's Chorea

Sydenham's Chorea Sydenham's Chorea. Acute rheumatic fever and chorea info | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Sydenham's Chorea Authored by , Reviewed by | Last edited 24 Feb 2017 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European (...) Guidelines. You may find the article more useful, or one of our other . In this article In This Article Sydenham's Chorea In this article Synonym: St Vitus' dance Sydenham's chorea is a neurological manifestation of rheumatic fever (RF). Chorea (from the Greek word meaning 'dance') occurs in 20-40% of patients with RF [ ] . Although it is the most common cause of acute chorea worldwide, cases are now rare in the developed world [ ] . An autoimmune process is triggered after infection with group A beta

2008 Mentor

178. Oral contraceptive induced chorea: another condition associated with anti-basal ganglia antibodies. (PubMed)

Oral contraceptive induced chorea: another condition associated with anti-basal ganglia antibodies. Use of oral contraceptives is a recognised but infrequent cause of chorea. This type of chorea has usually been considered a reactivation of Sydenham's chorea by an unknown mechanism. A patient developed a chorea triggered by the use of oral contraceptives with no definite evidence of previous Sydenham's chorea or recent streptoccocal infections. However, the patient had positive anti-basal (...) ganglia antibodies, which supports an immunological basis for the pathophysiology of this chorea.

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2004 Neurosurgery and Psychiatry

179. Rheumatic chorea: relationship to systemic manifestations and response to corticosteroids. (PubMed)

Rheumatic chorea: relationship to systemic manifestations and response to corticosteroids. To describe Sydenham chorea among children in a cohort of patients with rheumatic fever (RF).An existing database was used to identify demographic characteristics, clinical manifestations, and therapy in persons with RF identified in Salt Lake City, Utah, from 1985 through January 2002.Of 584 cases in the database, 537 (91%) were new-onset RF (median age of 10 years) and 177 (33%) had chorea. Patients (...) with chorea were more often female (OR = 0.37, 95% CI = 0.25-0.55, P < .0001) and were less likely to have carditis or arthritis. Prednisone treatment may lead to a shortened course of chorea (4.0 weeks in prednisone-treated [n = 32] vs 9.0 weeks in untreated [n = 14]; P < .0001). Among 33 patients seen at a median of 10.3 years (range 6.3-14.9 years) after their initial bout of chorea, 20% reported residual tremor or mood swings. Ten of the 33 (30%) had one or more recurrences of chorea.Chorea affected

2007 Journal of Pediatrics

180. Rheumatic chorea in northern Australia: a clinical and epidemiological study (PubMed)

Rheumatic chorea in northern Australia: a clinical and epidemiological study To describe the epidemiology and clinical features of Sydenham's chorea in the Aboriginal population of northern Australia a review was conducted of 158 episodes in 108 people: 106 were Aborigines, 79 were female, and the mean age was 10.9 years at first episode. Chorea occurred in 28% of cases of acute rheumatic fever, carditis occurred in 25% of episodes of chorea, and arthritis in 8%. Patients with carditis (...) or arthritis tended to have raised acute phase reactants and streptococcal serology. Two episodes lasted at least 30 months. Mean time to first recurrence of chorea was 2.1 years compared with 1.2 years to second recurrence. Established rheumatic heart disease developed in 58% of cases and was more likely in those presenting with acute carditis, although most people who developed rheumatic heart disease did not have evidence of acute carditis with chorea. Differences in the patterns of chorea and other

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1999 Archives of Disease in Childhood

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