Corticosteroids and Chorea

Brown, W. Ted; Sanberg, Paul R.; McGeer, P. L.

doi:10.1001/archneur.1979.00500430082020

Cited by 8 publications

(5 citation statements)

References 5 publications

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“…3 The initial workup in the ED should include electrolytes including calcium and magnesium, an imaging study (computed tomography and/or magnetic resonance imaging), an erythrocyte sedimentation rate, and a pregnancy test in female patients of childbearing age. 37,38 In fact, intravenous methylprednisolone followed by prednisone (administered orally) successfully treated patients with refractory SC. A slitlamp examination looking for Keyser-Fleischer rings and copper and ceruloplasmin levels are useful for the consideration of Wilson disease.…”

Section: Discussionmentioning

confidence: 99%

Sydenham Chorea

Weiner¹,

Normandin²

2007

Pediatric Emergency Care

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Sydenham chorea (SC) is the neurological manifestation of rheumatic fever and is the most common acquired chorea in children. The disease presents as choreiform movements and behavioral changes after a streptoccocal throat infection. Although the incidence of SC has diminished because of aggressive antibiotic treatment, both isolated cases and epidemics persist, necessitating emergency physicians to be familiar with the disease. We describe the case of a 9-year-old girl with SC. A discussion of the pathophysiology, clinical presentation, and management of SC in the emergency department follows.

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Section: Discussionmentioning

confidence: 99%

Sydenham Chorea

Weiner¹,

Normandin²

2007

Pediatric Emergency Care

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“…The decision to develop immunosuppressive treatment of SC was based on the accumulating evidence that a dysfunctional immune response related to molecular mimicry between antigens of the β‐hemolytic group A Streptococcus and the basal ganglia plays a crucial role in the pathogenesis of SC3 as well as on the observation that at least 5% of patients fail to respond to conventional treatment, despite the development of severe side effects such as parkinsonism and dystonia. Moreover, there are previous studies suggesting that corticosteroids might improve chorea in rheumatic fever 8, 10–12. However, in all these articles the authors report their experience with steroids used in small, nonimmunosuppressive but anti‐inflammatory, doses and for a short period of time The format of the protocol (IV methyl‐prednisolone followed by p.o.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Sydenham chorea with corticosteroids

et al. 2003

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Despite treatment with valproic acid and neuroleptics, a significant proportion of patients with Sydenham chorea (SC) remain with chorea. We evaluated the effect of intravenous methyl-prednisolone followed by oral prednisone in patients with SC refractory to conventional treatment. Patients were enrolled in the study if they failed to improve with conventional treatment, despite the development of side effects. Chorea was rated on a 0 to 4 score. Five patients, 3 of them women, were included in the study. The median pretreatment rating score of the chorea was 3 (range, 3-4) and dropped to 1 (range, 0-2) after a median follow-up of 7 months (range, 3-7 months). Two patients developed Cushing syndrome. Our data suggest that intravenous methyl-prednisolone followed by oral prednisone is an effective and well-tolerated treatment of refractory SC.

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“…Steroid therapy of chorea is controversial but may improve symptoms in the Sydenham's type (5)(6)(7). No prospective double-blind study has been performed using steroids for the therapy of chorea.…”

Section: Discussionmentioning

confidence: 99%