Neuropsychiatric Disease and Treatment (Jul 2023)
Sydenham Chorea in Sudan; Presentation Panorama
Abstract
Etedal Ahmed A Ibrahim,1,2 Rogia Hussein Mohamed,3 Khabab Abbasher Hussien Mohamed Ahmed,4 Malaz Tarig AbdAlla Mohamed,4 Mohammed Mahmmoud Fadelallah Eljack5 1Department of Medicine, Al-Neelain University, Khartoum, Sudan; 2Department of Neurology, The National Centre for Neurological Sciences, Khartoum, Sudan; 3Department of Medicine, Latifa Hospital for Women and Children, Dubai, United Arab Emirates; 4Department of Medicine, University of Khartoum, Khartoum, Sudan; 5Department of Community Medicine, University of Bakht Alruda, Ad Duwaym, White Nile State, SudanCorrespondence: Mohammed Mahmmoud Fadelallah Eljack, Department of Community Medicine, University of Bakht Alruda, Ad Duwaym, White Nile State, Sudan, Tel +249964656914, Email [email protected]: Sydenham’s chorea (SC) is the most common form of acquired chorea in childhood, it is considered a neurological complication of streptococcal pharyngitis. In this study, we aimed to determine the clinical pattern, association of Sydenham’s chorea with other manifestations of acute rheumatic fever, and the laboratory findings of Sydenham’s chorea among Sudanese patients.Methods: A prospective cross-sectional study involving fifty patients of various ages diagnosed with Sydenham’s chorea and followed up at The National Center for Neurological Sciences from January 2017 to November 2019. Data were obtained after patients’ consent through personal interviews or personal review of patients’ records via a structured questionnaire composed of demographic data, symptoms, co-morbid illness, risk factors, physical examination, and related investigations.Results: About 50 patient was enrolled in this study with a median age of 13.7 years. Females were (n=35) (70%) and (30%) (n=15) s were males. Generalized chorea was seen in 33 (66%) and hemichorea in 17 (34%) patients. Weakness (38%) and hypotonia (46%) were common, such as behavior change (44%), dysarthria (70%), gait change (18%), and deterioration of handwriting (12%). Arthritis occurred in (36%), carditis in 30 (60%), both arthritis and carditis in 18 (36%), and pure chorea in 14 (28%). Erythema marginatum and subcutaneous nodules were not observed in our patients. Only 13 patients (26%) gave a history of pharyngitis.Conclusion: Sydenham chorea is more common in young female Sudanese, with a familial predominance and a tendency towards mitral valve disease. All pediatric Patients with chorea should be screened for Sydenham’s chorea.Keywords: Sydenham, chorea, acute rheumatic fever, presentations, psychiatric
