NINDS Sydenham Chorea Information Page

There is no specific treatment for SD.  For people with the mildest form, bed rest during the period of active movements is sufficient.  When the severity of movements interferes with rest, sedative drugs, such as barbiturates or benzodiazepines, may be needed.  Antiepileptic medications, such as valproic acid, are often prescribed.  Doctors also recommend that children who have had SD take penicillin over the course of the next 10 years to prevent additional manifestations of rheumatic fever. 

Most children recover completely from SD, although a small number will continue to have disabling, persistent chorea despite treatment.   The duration of symptoms varies, generally from 3 to 6 weeks, but some children will have symptoms for several months.  Cardiac complications may occur in a small minority of children, usually in the form of endocarditis.  In a third of the children with the disease, SD will recur, typically 1 ½ to 2 ½ years after the initial attack.  Researchers have noted an association between recurrent SD and the later development of the abrupt onset forms of obsessive-compulsive disorder, attention deficit/hyperactivity disorder, tic disorders, and autism, which they call PANDAS, for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus infection.  Further studies are needed to determine the nature of the association and the biological pathways that connect streptococcal infection, autoimmune response, and the later development of these specific behavioral disorders.

The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) conduct research related to SD in laboratories at the NIH, and support additional research through grants to major medical institutions across the country.  Currently, researchers are studying how the interplay of genetic, developmental, and environmental factors could determine a child’s vulnerability to SD after a GABHS infection.  Other researchers are exploring whether children whose symptoms either begin or get worse following a GABHS infection share a common set of abnormal biomolecular pathways responsible for their similar clinical symptoms.