Sydenham chorea is a neuropsychiatric manifestation of acute rheumatic fever (ARF), characterised variably by chorea, decreased muscle tone, and in some cases psychiatric and behavioural symptoms such as obsessive-compulsive symptoms and hyperactivity. This protocol addresses the management of ARF specifically in patients presenting with this manifestation.
For moderate chorea, management combines supportive measures with anticonvulsant therapy. The specific agents, their selection criteria, and the full clinical algorithm are detailed in the complete structured protocol.
Reduction (though not necessarily elimination) of choreiform movements. A response to treatment may not be seen for one to two weeks.
Sydenham chorea is a neuropsychiatric manifestation of ARF characterised variably by chorea, decreased muscle tone, and in some cases, psychiatric and behavioural symptoms such as obsessive-compulsive symptoms and hyperactivity.
Anticonvulsant therapy usually with carbamazepine or sodium valproate (if no risk of pregnancy).
Carbamazepine is generally recommended as the first-line agent due to its preferable safety profile, followed by sodium valproate.
A response to treatment may not be seen for one to two weeks, and successful medication may only reduce, but not eliminate, the symptoms of Sydenham chorea.
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